Salmon JH, et al. - The incidence of serious infusion-related reactions (SIRRs) in rheumatoid arthritis (RA) treated with non-TNF-targeted biologics is assessed in this study. The outcome of this study suggests that the SIRRs are slightly more frequent than in clinical trials and rarely life-threatening in daily practice. They also mentioned that serological status (anti-CCP positivity) and absence of concomitant treatment with a synthetic DMARD, increase the risk of SIRR in common practice.

Methods

• For this study, they used prospective registry data.
• They analyzed data from three independent prospective registers, namely autoimmunity and rituximab, Orencia (abatacept) and RA (ORA) and Registry RoAcTEmra (tocilizumab), promoted by the French Society of Rheumatology and including patients with RA.
• SIRRs were characterized by an occurrence amid or within 24 h of an infusion and requiring discontinuation of treatment.
• Attributes of patients with SIRRs were extracted from the electronic database.

Results

• Among the 4145 patients, SIRRs occurred in 100 patients: 56 patients with the rituximab cohort (2.8% or 0.7/100 patient-years), 15 with the abatacept cohort (1.5% or 0.6/100 patient-years) and 29 with tocilizumab (1.9% or 1/100 patient-years).
• In this study, no fatal SIRR occurred.
• A previous mild infusion reaction to non-TNF-targeted biologics was seen in a quarter of patients with SIRRs.
• Positive anti-CCP was related to a higher risk of SIRR (odds ratio = 2.5; 95% CI: 1.01, 6.17) after pooled multivariate analysis.
• Absence of concomitant treatment with a synthetic DMARD tended to be related to a higher risk of SIRR (odds ratio = 1.67; 95% CI: 1.00, 2.86).