Risk of Sepsis or Death Lower with Biologics in Rheumatoid Arthritis Save

Researchers from Germany have analyzed their large prospective rheumatoid arthritis (RA) registry to address whether being on biologic therapies leads to poorer outcomes - namely sepsis or death, following a serious infection (SIE).

They examined the outcomes of SIEs in 947 RA patients enrolled in the German biologics RABBIT registry, specifically noting the following outcomes (1) recovery, (2) sepsis following SIE (≤30 days), or (3) death after SI, without known sepsis (occurring in ≤90 days). 

Sepsis within 30 days of an SIE was reported in 14.2% of patients and 85 of these were fatal.  Death (without sepsis) occurred in 5.6% of patients within 90 days of SIE.  

The adjusted risk of developing sepsis increased with age and was higher in patients with chronic renal disease.

Patients treated with biologic DMARDs (bDMARDs) at the time of SIE, had a lower risk of death than those with conventional synthetic (cs)DMARDs (OR: 0.56, 95% CI 0.38 - 0.81).

Risk factors of fatal SIE were higher age, use of glucocorticoids at higher doses and heart failure.

Patients treated with bDMARDs and those with better physical function had a significantly lower mortality risk.

These findings suggest that better control of inflammation may limit the mortal risks imposed by a serious infection in treated RA patients.