Immunosuppressive Medications and Nonserious Infections in People With Rheumatoid Arthritis: A Prospective Cohort...

Area of Science:

• Rheumatology
• Infectious Disease Epidemiology
• Pharmacovigilance

Background:

• Rheumatoid arthritis (RA) patients face higher serious infection risks.
• Nonserious infection risks associated with RA medications are less understood.
• Prospective cohort studies are crucial for evaluating medication-associated infection risks.

Purpose of the Study:

• To investigate the association between rheumatoid arthritis (RA) medications and the risk of nonserious infections.
• To compare infection risks among patients using biologics, JAK inhibitors, and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs).

Main Methods:

• A prospective cohort study involving 351 adults with RA recruited remotely.
• Monthly surveys were used to assess medication use and infection reports.
• Statistical models adjusted for confounders to evaluate medication-infection associations.

Main Results:

• Biologic or JAK inhibitor use was not linked to increased nonserious infection risk compared to csDMARDs.
• Glucocorticoid use (≥10 mg/day) showed a numerical increase in infection risk (OR 1.94).
• Season, prior infection, functional status, and rural residence were significant infection risk factors.

Conclusions:

• Biologics and JAK inhibitors do not appear to elevate nonserious infection risk in RA patients.
• Nonserious infections may be more influenced by environmental exposures and overall health status.
• Future research should examine the impact of temporarily stopping RA medications during infections.