Some evidence for efficacy of biologics for rheumatoid arthritis

Clinical question: 
How effective are biologics in patients with rheumatoid arthritis (RA)?
Bottom line: 
Abatacept, adalimumab, etanercept, infliximab, rituximab and (to a lesser extent) anakinra may improve signs of rheumatoid arthritis, including the number of tender or swollen joints and other outcomes, such as pain and disability. Fewer withdrawals due to adverse effects were reported for etanercept than for adalimumab, anakinra and infliximab.
Caveat: 
The findings should be interpreted with caution due to heterogeneity in the characteristics of trial populations. There is insufficient information about possible side effects and complications. This is particularly true for rare but serious side effects. Possible side effects may include a serious infection or upper respiratory infection. An association between use of biologics and an increased rate of lymphomas has been reported. Most of the trials lasted only 6 to 12 months.
Context: 
Biologics are a group of disease-modifying anti-rheumatic drugs that suppress the immune system and reduce inflammation in the joints. Suppressing the immune system can make it slightly harder to "fight off" infections but also helps to stabilise an overactive immune system. The aim of treatment is to help prevent damage to the joints by reducing inflammation.
Review CD#: 
CD007848
PEARLS No: 
217
Date: 
December, 2009
Authored by: 
Brian R McAvoy