Friday, 21 Feb 2020

You are here

Polypharmacy Blunts Responses and Ups the Safety Risks

A study from the British Society for Rheumatology Biologics Register (BSRBR-RA) demonstrates that polypharmacy is a predictor of lower treatment responses and more serious adverse events (SAEs) in rheumatoid arthritis (RA) patients.

A review of this 22,005 RA patients enrolled in a prospective observational cohort study assessed the influence of polypharmacy on the odds of a EULAR 'good response' and the risk of SAE after 12 months of biologic therapy.

They identified the addition of each medication reduced the odds of a EULAR good response by 8% [odds ratios 0.92 (95% CI 0.91, 0.93) P < 0.001] or  3% in an adjusted model [adjusted odds ratios 0.97 (95% CI 0.95, 0.98) P < 0.001].

They also demonstrated a greater effect for polypharmacy than comorbidity on clinical outcomes.

Polypharmacy also contributed to adverse events as each additional medication yielded a 13% increased risk of an SAE [hazard ratio 1.13 (95% CI 1.12, 1.13) P < 0.001] and 6% in the adjusted model [adjusted hazard ratio 1.06 (95% CI 1.05, 1.07) P < 0.001].

There was no difference in SAE risk when comparing polypharmacy and comorbidity.

Physicians should be cognizant of the detrimental effect of polypharmacy on efficacy and safety outcomes in RA patients receiving biologic therapy. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Tofacitinib Effective in Refractory Still's Disease

Fourteen cases reported from mainland China suggest that tofacitinib (TOFA) may be effective in patients with refractory adult-onset Still’s disease (AOSD), further adding to a growing list of potential use of JAK inhibition in managing inflammatory, and now autoinflammatory, disease.

QD Clinic - Hepatitis B and Biologics

QD Clinic - Lessons from the clinic Active HBV infection (HGsAg+) on anti-viral therapy but needs a biologic - what should you use?

Biosimilars for Rheum Disease: Failure to Launch

The availability of biologic biosimilars has thus far had negligible impact on prescribing practices in the United States, in stark contrast to what has been observed in some European countries, researchers reported.

Best of 2019 - Is Methotrexate Necessary with Tofacitinib?

Rheumatoid arthritis patients taking tofacitinib (Xeljanz) plus methotrexate who achieved low disease activity (LDA) may be able to withdraw from the latter agent without significant worsening of disease activity, a researcher reported at EULAR 2019 in Madrid.

Best of 2019 - Ups and Downs with Abatacept

Two recent studies have examined the effect of starting abatacept upon the risk of serious hospitalized infections or cancer, showing divergent results from claims data analyses.