New study unveils the impact of non-serious infections during biological treatment for rheumatoid arthritis

A recent article published in the PLoS One journal offers an overview of the burden experienced by patients with non-serious infections during biological treatment in rheumatoid arthritis (RA). Although these infections are not life-threatening, a significant proportion of patients suffer from them at some point during their treatment. The study data reveals that even such non-serious infections have a noteworthy impact on the patient’s quality of life. 

Bergmans and colleagues conducted the Dutch Biologic Monitor, the prospective observational study involving adults diagnosed with rheumatoid arthritis and undergoing biological treatment. Participants completed bimonthly questionnaires detailing adverse drug reactions (ADRs) they experienced, along with associated impact scores. The final analysis comprised 586 patients. Of these, 85 patients (14.5%) reported a total of 421 ADRs deemed probable or definite infections by experts. The burden experienced by patients varied depending on the specific ADR. Upper respiratory tract infections were the most commonly reported, characterized by a high rate of recurrence or persistence. The median impact score for these infections remained stable over time at 3.0 (IQR 2.0-3.0). In this real-life cohort of RA patients undergoing biological therapy, non-serious infections markedly surpassed serious infections, with rates of 77.1 and 1.3 per 100 patient years, respectively. Notably, upper respiratory tract infections were assessed to have an average burden, persisting at a consistent level over an extended duration. 

Since their introduction to the market in the late nineties, the utilization of biologicals has been linked to an elevated risk of serious infections, a subject extensively scrutinized in various studies. Notably, randomized controlled trials (RCTs) have shed light on the prevalence of non-serious infections, which, according to published data, can be up to ten times more frequent than serious infections among users of biologicals in RA treatment. Infections rank prominently among the reported adverse reactions in RA patients undergoing biological therapy. However, unlike their serious counterparts, non-serious infections have not received commensurate attention in scientific literature. This lack of focus might stem from patients typically not seeking healthcare professional assistance for non-serious infections, such as the common cold, potentially leading to an underestimation of their incidence and significance by healthcare providers. 

Raising awareness about the affected organ systems and the burden of non-serious infectious ADRs could empower healthcare professionals to administer timely treatment and potentially prevent these occurrences, thereby reducing both their personal and socioeconomic impact. Future research endeavors should prioritize investigating the occurrence and burden of non-serious infections, employing diverse methodologies to assess their impact on quality of life. By recognizing the consequences of recurrent and chronic non-serious infections, healthcare professionals may intervene promptly to mitigate their effects, ultimately alleviating the associated personal and socioeconomic burdens. 


Bergmans B, Jessurun N, van Lint J, Murk JL, van Puijenbroek E, de Vries E. Burden of non-serious infections during biological use for rheumatoid arthritis. PLoS One. 2024;19(2):e0296821.  


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