News: Certain inhibitors associated with increased bloodstream infections in rheumatoid arthritis, study finds

Rheumatoid arthritis (RA) patients who currently use TNF inhibitors or interleukin-6 (IL-6) receptor inhibitors had higher rates of first-time bloodstream infections than those who had no current use of biologic and targeted synthetic disease-modifying antirheumatic drugs, a recent study found.

Researchers sought to evaluate the association between the use of b/tsDMARDs and the risk for bloodstream infections in patients with RA. The analysis included 4,128 patients with RA who developed a first-time bloodstream infection between 2010 and 2024 and 20,582 matched control individuals with RA who were free of bloodstream infections on the matched date.

The use of TNF inhibitors, abatacept, IL-6 receptor inhibitors, or JAK inhibitors within 180 days before the first positive blood culture was compared with no use these therapies. The researchers also evaluated the influence of concomitant therapies and differences across drug classes and individual agents.

Compared with current non-users of b/tsDMARDS, rates of bloodstream infections were higher among users of TNF inhibitors and IL-6 receptor inhibitors. Users of abatacept and JAK inhibitors showed no significant difference.

Among TNF inhibitors, golimumab and infliximab were associated with significantly higher rates of bloodstream infections. Among IL-6 receptor inhibitors, tocilizumab was associated with higher rates. Users of IL-6 receptor inhibitors had a 42% higher rate of bloodstream infections than users of TNF inhibitors, whereas users of JAK inhibitors had a similar rate.

Among users of TNF inhibitors, concomitant use of oral glucocorticoids was associated with higher rates of bloodstream infections than monotherapy, with a similar pattern observed among users of IL-6 receptor inhibitors.

"Concomitant glucocorticoid use was associated with substantially higher rates among TNFi [TNF inhibitor] and IL-6Ri [IL-6 receptor inhibitor] users, underscoring the importance of minimizing glucocorticoid exposure when possible," the authors of the study wrote.

Editor’s note: To read the full study, click here. To read additional coverage from Medscape, click here.