Safety of Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis: A Longitudinal Analysis
By
Kuan Peng
Vincent K. C. Yan
Shirley C. W. Chan
Ju-Young Shin
Edward Chia‑Cheng Lai
Nicole L. Pratt
Esther W. Y. Chan
Chak-sing Lau
Xue Li
June 26, 2026
Clinical Scorecard: Long-Term Safety Assessment of Biologic and Targeted Synthetic DMARDs in Patients with Rheumatoid Arthritis: A Longitudinal Study
At a Glance
Category Detail
Condition Rheumatoid Arthritis Key Mechanisms Biologic and targeted synthetic disease-modifying antirheumatic drugs (b/ts DMARDs) manage RA by targeting specific pathways involved in inflammation. Target Population Adult patients (age ≥18 years) with rheumatoid arthritis initiated on at least one b/ts DMARD. Care Setting Population-based study using electronic medical records from a territory-wide database.
Key Highlights
Long-term safety profiles of b/ts DMARDs are broadly similar across agents. Tocilizumab linked to higher hospitalization rates compared to etanercept. Tofacitinib associated with an elevated risk of gastritis. Guideline-Based Recommendations
Diagnosis
Identification of RA based on the International Classification of Diseases, Ninth Revision, Clinical Modification (714.0). Management
Consider efficacy and patient preference when selecting b/ts DMARDs. Monitoring & Follow-up
Monitor for serious infections, cardiovascular events, and malignancies associated with b/ts DMARDs. Risks
Increased risk of serious infections, cardiovascular events, and malignancies with certain b/ts DMARDs. Patient & Prescribing Data
Adult patients with rheumatoid arthritis initiated on b/ts DMARDs from 2009 to 2022.
Robust evidence from observational studies is necessary to inform treatment decisions.
Clinical Best Practices
Utilize advanced statistical methods to account for biases in observational data. Employ marginal structural models to evaluate drug safety in real-world populations. Related Resources & Content
