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Occurrence of Serious Infection in Patients with Rheumatoid Arthritis Treated with Biologics and Denosumab Observed in a Clinical Setting.

Occurrence of Serious Infection in Patients with Rheumatoid Arthritis Treated with Biologics and Denosumab Observed in a Clinical Setting.
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Lau AN, Wong-Pack M, Rodjanapiches R, Ioannidis G, Wade S, Spangler L, Balasubramanian A, Pannacciulli N, Lin CJF, Roy-Gayos P, Bensen WG, Bensen R, Adachi JD,


Lau AN, Wong-Pack M, Rodjanapiches R, Ioannidis G, Wade S, Spangler L, Balasubramanian A, Pannacciulli N, Lin CJF, Roy-Gayos P, Bensen WG, Bensen R, Adachi JD, (click to view)

Lau AN, Wong-Pack M, Rodjanapiches R, Ioannidis G, Wade S, Spangler L, Balasubramanian A, Pannacciulli N, Lin CJF, Roy-Gayos P, Bensen WG, Bensen R, Adachi JD,

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The Journal of rheumatology 2017 11 15() pii jrheum.161270
Abstract
OBJECTIVE
Previous studies combining biologic disease-modifying antirheumatic drugs (bDMARD) to treat rheumatoid arthritis (RA) have shown an increased risk of infection. However, the risk of infection with concurrent use of denosumab, a biologic agent for the treatment of osteoporosis, and a bDMARD remains unclear. Here, we evaluated the incidence of serious and opportunistic infections in patients treated concurrently with denosumab and a bDMARD and patients treated with a bDMARD alone.

METHODS
A chart review of patients with RA from 2 Canadian rheumatology practices between July 1, 2010, and July 31, 2014, identified 2 groups of patients: those taking denosumab and a bDMARD concurrently (concurrent group) and those taking only a bDMARD (biologic-alone group). Patients were followed from the time of initiation of denosumab, or a matched index date for the biologic-alone group, to the end of the study or loss to followup. Instances of serious or opportunistic infections were recorded.

RESULTS
A total of 308 patients (n = 102 for the concurrent group and n = 206 for the biologic-alone group) were evaluated. Within the concurrent group, 3 serious infection events occurred. Within the biologic-alone group, 4 serious infection events and 1 opportunistic infection event occurred. In both groups, all patients with serious or opportunistic infection recovered, and there were no instances of death during the study period.

CONCLUSION
This study demonstrated a low occurrence of serious and opportunistic infections in patients with RA taking bDMARD, including patients with concurrent denosumab use.

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