Long-Term Benefits, Risks of Biologic Disease-Modifying Anti-Rheumatic Drugs in Patients with RA

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Two decades have passed since the first biologic disease-modifying anti-rheumatic drug (bDMARD) was approved. Studies on the long-term use of biologics in different disease states, such as for cardiovascular disease (CVD) and malignancy, as well as for knee/hip replacement, reveal some encouraging news.

In clinical trials, bDMARDs have been shown to increase the risk of infection and malignancy, but they are also known for better liver and kidney tolerance among patients with rheumatoid arthritis (RA) than synthetic DMARDs (sDMARDs). bDMARDs also have significant clinical benefits over sDMARDs when controlling moderate to severe autoimmune diseases caused by uncontrolled chronic inflammation, such as rheumatoid arthritis (RA), psoriasis, psoriatic arthritis and polymyalgia rheumatica, but heretofore evidence is lacking that they reduce comorbidities in RA. The most common comorbidities among RA patients are CVD and joint damage.

A systematic literature review, which informed the 2016 update of the EULAR recommendations for RA management, studied the safety and efficacy of synthetic and biologic DMARDs in RA patients and showed that bDMARDs have favorable effects on CV events and total knee/hip replacement.¹

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