All biologic drugs for arthritis not equal: some pose more risk

A UAB review of biologics, a new class of drugs used to treat conditions such as rheumatoid arthritis, shows that some are safer for human use than others.

Some biologic drugs may pose more risk than others, according to a new systematic review by a University of Alabama at Birmingham researcher, who says study is needed to establish their comparative safety. Biologics are a broad class of drugs — based on biological molecules — used to reduce inflammation in diseases such as rheumatoid arthritis and inflammatory bowel disease.

pills“Although effective, it is thought that some biologics may have rare but serious side-effects related to their immune-suppressing activities such as increased risk of infections and reactivation of tuberculosis,” said study author Jasvinder Singh, M.D., M.P.H., associate professor in the division of immunology and rheumatology.  

The review, published in the Cochrane Library, is based on data from 50,010 patients in 163 studies focused on nine different biologics used to treat arthritis and other conditions. Adverse events were more likely to occur among those taking biologics than those in the control group.

When compared to each other, adalimumab and infliximab caused more adverse events, whereas abatacept and anakinra were associated with fewer serious adverse events. Taking certolizumab pegol was more likely to result in a serious infection than several other biologics.

Some adverse events, such as congestive heart failure and cancer, were so rare that it was difficult to establish any link to the drugs. “But there were few cases in total, so we can’t be very confident about these results,” said Singh.

“These results need to be taken cautiously,” said Singh. “The data provides some guidance for clinicians and patients regarding the safety of different biologic drugs, but these are not head-to-head trials. There still is an urgent need for more research into the safety of these drugs, and, in particular, their comparative safety.”