How effective and how safe are biologic medications in the treatment of rheumatoid arthritis?


A close up of an older person massaging their fingers

Rheumatoid arthritis, a chronic inflammatory disease, affects approximately 1% of the Canadian population and is twice as common in women as in men. The disease is very painful and brings with it functional disability, psychological distress, decreased ability to work and premature death.

Treatment for rheumatoid arthritis (RA) has changed drastically in the last decade with new medications, called biologics, successfully treating even the most severe RA cases. However, as is the case with many new drug treatments, early benefits can be seen but the potential for longer-term health risks is less clear.

Diane Lacaille is a Professor at the University of British Columbia and a Senior Research Scientist at the Arthritis Research Centre of Canada. She is leading a research study which will use observational studies and linked administrative data to evaluate the benefits and risks of biologics in the treatment of RA in British Columbia.

“Currently, the use of biologics has been somewhat limited by their high cost and concerns that have been raised over the potential risks of adverse effects such as infections and cancer,” says Professor Lacaille. “It is important for people with arthritis and health care providers to know the actual risk of adverse events of biologics, when used in real-life conditions over long periods of time, and to know whether the risk of these complications varies across classes of biologics.”

“As biologics have been shown to be effective in preventing joint damage, it is expected that their use will lead to a reduction in joint replacement surgeries, “continues Professor Lacaille. “However, this has not yet been demonstrated in research and is important to health policy planners and insurance companies who are concerned about the rising cost of this class of medications.”

The study will also examine the quality of care experienced by people with RA with co-morbidities (such as cardiovascular disease, diabetes mellitus and osteoporosis) to see how it compares to members of the general population, and whether treatment with effective medications reduces these risks and the risk of premature mortality. 

For the project, PopData will link data from the BC Ministry of Health, the BC Cancer Agency, the BC Vital Statistics Agency, Vancouver Coastal Health and Statistics Canada Income Band with researcher-collected laboratory and survey data.

The project is funded by the Canadian Institutes of Health and the Canadian Arthritis Network.