Grant: Knowledge Synthesis Grant - PA: Arthritis

Inflammatory arthritis, including rheumatoid arthritis (RA), leads to significant pain, disability and a reduced quality of life. In the last two decades, the introduction of biologic drugs has revolutionized the treatment of arthritis and other disease conditions such as skin, inflammatory bowel, and neuromuscular diseases. These drugs specifically target parts of the immune system and many studies have shown that biologics offer a clinically important improvement in pain and function in patients not responding to traditional therapies. Biologics are viewed by patients and practitioners as a major break-through in the management of arthritis; however, they are an expensive therapy. The mechanism of action of the biologics is to modulate the immune response, so the risk of adverse events such as serious infections and malignancies is an important concern. The goal of this review is to systematically evaluate the potential harms of nine biologic drugs approved for use in RA and compare the risk of harms between different biologics. Given the large, rising interest in biologics, patients and practitioners need a clearer understanding of the risks associated with the use of biologics. It is vital to determine the safety profile of these drugs in order to allow patients, clinicians, and policy makers to make an informed decision on their use.