New classes of drugs are biologic disease-modifying anti-rheumatic drugs (bDMARDs) and Januskinase inhibitors (JAKi). At the 2021 EULAR congress, Strangfeld and colleagues shared new data assessing the effects of these medications on the risk of serious infections in elderly people with RA. RA is an inflammatory autoimmune disease that causes pain, swelling, and stiffness in the joints, but it also affects other organ systems through underlying systemic inflammation, causing for example cardiovascular diseases or fatigue.
RABBIT is a prospective, observational cohort study in Germany. Patients with RA are enrolled when they start a new DMARD after failing at least one conventional synthetic treatment (csDMARD). This analysis included 2,274 people over the age of 70. In total, 626 serious infections were observed in 425 of these people.
Adjusted for those differences, serious infections were less likely in patients receiving bDMARDs or JAKi compared to csDMARDs, but this was not statistically significant. Associations with an increased risk of serious infections were seen for glucocorticoid use, higher disease activity, and having another underlying disease such as chronic pulmonary or kidney disease, or diabetes. The authors also found that better physical capacity was associated with a decreased risk of having a serious infection.
Overall, the results suggest that treatment with these new classes of drugs is not associated with an increased risk of serious infection in elderly RA patients above 70 years of age.