Related Experiment Video

Updated: May 2, 2026

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
07:37

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice

Published on: June 6, 2025

1.5K

Biologic therapies in rheumatoid arthritis and the risk of opportunistic infections: a meta-analysis

Irene S Kourbeti1, Panayiotis D Ziakas1, Eleftherios Mylonakis1

  • 1Infectious Diseases Division, Rhode Island Hospital Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 21, 2014
PubMed
Abstract

Insights

Biologic agents for rheumatoid arthritis (RA) slightly increase the risk of opportunistic infections (OIs), particularly mycobacterial and viral types. This risk does not appear to impact overall mortality, but further research is needed.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Pharmacology

Background:

  • Biologic agents are widely used for treating rheumatoid arthritis (RA).
  • The association between biologic agents and opportunistic infections (OIs) requires thorough investigation.

Purpose of the Study:

  • To review the association between biologic agents used in RA treatment and the risk of opportunistic infections (OIs).
  • To specifically examine fungal, viral (herpesvirus), tuberculosis, and other mycobacterial infections.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Searches were performed in PubMed and EMBASE up to June 24, 2013.
  • Eligible RCTs compared approved biologic agents against controls in RA patients, reporting OI risks.

Main Results:

  • 70 eligible trials included 32,504 patients (21,916 on biologics, 10,588 on placebo).
  • Biologic agents significantly increased the risk of OIs (OR, 1.79; 95% CI, 1.17-2.74).
  • Increased risks were noted for mycobacterial (OR, 3.73) and viral (OR, 1.91) infections; fungal infections and overall mortality were not significantly affected.

Conclusions:

  • Biologic agents are associated with a small but significant increased risk of specific OIs in RA patients, notably mycobacterial and viral infections.
  • The observed increase in OI risk does not appear to elevate overall mortality.
  • Large registries are necessary to precisely determine the impact of different OIs and to compare the safety profiles of various biologic agents.
Keywords:
biologicinfectionsmeta-analysisopportunisticrheumatoid arthritis

More Related Videos

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain04:50

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

1.5K

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
880
Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
14.1K
Inflammatory Bowel Disease IV: Pharmacological Management01:29

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
1.1K
Genome-wide Association Studies-GWAS01:11

Genome-wide Association Studies-GWAS

Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
12.6K
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches01:23

Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches

Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
627
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
755