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Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

15.09. - 18.09.2021, virtuell

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The incidence of serious infections in patients with rheumatoid arthritis receivingbDMARDs

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  • Eugenia Aronova - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Galina Lukina - Moscow Clinical Scientific Center named after Loginov A. S., Moscow
  • Galina Gridneva - V.A. Nasonova Research Institute of Rheumatology, Moscow
  • Anastasia Kudryavtceva - V.A. Nasonova Research Institute of Rheumatology, Moscow

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. Deutscher Rheumatologiekongress 2021, 49. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 35. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). sine loco [digital], 15.-18.09.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocRA.51

doi: 10.3205/21dgrh132, urn:nbn:de:0183-21dgrh1327

Published: September 14, 2021

© 2021 Aronova et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: Infections are a serious complication and often lead to discontinuation of antirheumatic therapy. The aim of our study was to study infectious complications of bDMARDs therapy, to analyze the frequency of withdrawal bDMARDs due to the development of infectious complications.

Methods: The ambispective analysis included data on 505 cases of prescribing biologics with different mechanism of action in 188 patients with rheumatoid arthritis (160 women, 28 men).

Results: Patients in the study group received from 2 to 5 bDMARDs, mediana (25% -75%) 2 (2-3). Biologics were discontinued 326 times, of which due to the development of serious adverse reactions - 70 times, of which due to the development of infectious complications - 16 times (5% of all cases of discontinuations, 29% of all serious adverse reactions). During treatment with the first bDMARD, infectious complications that required discontinuation of the drug developed in 5.3% of cases (N = 10), with the second bDMARD - in 5.2% of cases (N = 4), no statistical differences were found between these groups. On the background of treatment with the third bDMARD, infectious complications led to the withdrawal of treatment in 14.3% of cases (N = 1), in the fourth - 0%, and in the fifth - 33.4% of cases (N = 1). There was no correlation between the number of sequentially prescribed biologics and the incidence of infectious complications. Most often, serious infections developed during treatment with drugs of the TNF-α inhibitor group (infliximab, etanercept, adalimumab, golimumab, certolizumab pegol) and tofacitinib. Out of 16 cases of infectious complications, 5 were associated with tuberculosis infection.

Conclusion: Infectious complications make up a significant proportion (29%) of all serious adverse reactions leading to the discontinuations of biologics in patients with rheumatoid arthritis. The frequency of discontinuation of bDMARDs due to infectious complications was about 5% and did not change during treatment with both the first and second biologics. It is necessary to remain alert about tuberculosis infection and examine patients before prescribing and during treatment with bDMARDs.

Disclosures: None declared