Some evidence for efficacy of biologics for rheumatoid arthritis

January 01, 0001

Some evidence for efficacy of biologics for rheumatoid arthritis

Clinical Question:How effective are biologics in patients with rheumatoid arthritis (RA)?

Bottom line: Abatacept, adalimumab, etanercept, infliximab, rituximab and (to a lesser extent) anakinra may improve signs of rheumatoid arthritis, including the number of tender or swollen joints and other outcomes, such as pain and disability. Fewer withdrawals due to adverse effects were reported for etanercept than for adalimumab, anakinra and infliximab.

Caveat: The findings should be interpreted with caution due to heterogeneity in the characteristics of trial populations. There is insufficient information about possible side effects and complications. This is particularly true for rare but serious side effects. Possible side effects may include a serious infection or upper respiratory infection. An association between use of biologics and an increased rate of lymphomas has been reported. Most of the trials lasted only 6 to 12 months.

Context: Biologics are a group of disease-modifying anti-rheumatic drugs that suppress the immune system and reduce inflammation in the joints. Suppressing the immune system can make it slightly harder to "fight off" infections but also helps to stabilise an overactive immune system. The aim of treatment is to help prevent damage to the joints by reducing inflammation.

Cochrane Systematic Review: Singh JA et al. Biologics for rheumatoid arthritis: an overview of Cochrane reviews. Cochrane Reviews 2009, Issue 4. Article No. CD007848. DOI: 10.1002/14651858.CD007848.pub2. This overview covers 6 Cochrane reviews involving 31 studies and more than 9500 participants. One study did not report the number of participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 217, February 2010.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: M. Musculoskeletal. Keywords: rheumatoid arthritis, treatment, biologics, abatacept, adalimumab, etanercept, infliximab, rituximab, anakinra
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 4 May 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.