title: What is the impact of biologic therapies on common co-morbidities in patients with rheumatoid arthritis?
abstract: Biologic therapies have revolutionised disease control in patients with rheumatoid arthritis (RA). Theoretically, they have the potential to influence co-morbid disease associated with RA through better control of systemic inflammation. Conversely, co-morbidity may occur as an adverse effect of the drugs. The latest evidence from observational data shows an increased risk of infection in the first 6 months of treatment with tumour necrosis factor inhibitor (TNFi) therapies and potentially other biologic therapies. Rates of infection after the first 6 months decrease and become comparable to patients with RA treated with conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs). TNFi also appear to reduce the risk of cardiovascular disease in these patients, in particular ischaemic heart disease. TNFi treatment may be associated with a small increase in the risk of developing squamous cell carcinoma of the skin; in terms of other cancers, rates appears to be no different to those seen in patients treated with csDMARDs. There is a paucity of data on the impact of other biologic therapies and the effect of all biologic therapies on other common co-morbidities.
authors.affiliation: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK.
authors.forename: Jenny
authors.identifier: 0000-0003-2497-4080
authors.initials: J
authors.lastname: Humphreys
authors.affiliation: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
authors.forename: Kimme
authors.initials: K
authors.lastname: Hyrich
authors.affiliation: Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, UK. deborah.symmons@manchester.ac.uk.|NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. deborah.symmons@manchester.ac.uk.|Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, UK. deborah.symmons@manchester.ac.uk.
authors.forename: Deborah
authors.initials: D
authors.lastname: Symmons
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015897:Comorbidity; D006801:Humans
chemical_list: D018501:Antirheumatic Agents