ArticleArthritis care & research2024
Frailty and Risk of Serious Infections in Patients With Rheumatoid Arthritis Treated With Biologic or Targeted-Synthetic Disease-Modifying Antirheumatic Drugs.
Article in Arthritis care & research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 15 citations in OpenAlex.
- Review
- Association between rheumatoid arthritis, frailty status, mortality and anti-cancer therapy: a retrospective SEER-Medicare analysis in patients with non-metastatic renal cell carcinoma.Annals of translational medicine · 2026Article
- Geroscience insights into difficult-to-treat rheumatoid arthritis: the role of unhealthy aging, comorbidity, and therapeutic complexity.GeroScience · 2026Review
- Frailty as an indicator of adverse health outcomes in rheumatoid arthritis: a multicenter cross-sectional study.Arthritis research & therapy · 2026Article
- Japanese evidence on Janus kinase inhibitors for rheumatoid arthritis: a narrative review of risk-optimized use.Frontiers in pharmacology · 2026Review
- Frailty in rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis: Current evidence and knowledge gaps.Therapeutic advances in musculoskeletal disease · 2026Review
- Serious infection risk in older adults with RA receiving biologic or targeted synthetic DMARDs: the role of age at disease onset.Therapeutic advances in musculoskeletal disease · 2026Article
- Frailty carries an increased risk of death in rheumatoid arthritis.Seminars in arthritis and rheumatism · 2025Article
- Late Onset Rheumatoid Arthritis.Aging and disease · 2025Review
- Association Between Rheumatoid Arthritis, Frailty Status, and Mortality in Older Adults with Bladder Cancer.Clinical genitourinary cancer · 2025Article
- The distribution of the frailty index among different arthritis patients and the association between the frailty index and mortality in rheumatoid arthritis patients among U.S. adults (results from NHANES 1999-2018).Aging clinical and experimental research · 2025Observational
- Frailty integration in medical specialties: Current evidence and suggested strategies from the Clin-STAR frailty interest group.Journal of the American Geriatrics Society · 2025Review
- Frailty and cardiovascular safety of JAK inhibitors versus TNF inhibitors in rheumatoid arthritis: a real-world comparative study of drug effects and patient profiles.Frontiers in pharmacology · 2025Article
- Incidence Rates of Infections in Rheumatoid Arthritis Patients Treated with Janus Kinase or Interleukin-6 Inhibitors: Results of a Retrospective, Multicenter Cohort Study.Journal of clinical medicine · 2024Article
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Authors and funding
12 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveIt remains unknown whether frailty status portends an increased risk of adverse outcomes in patients with rheumatoid arthritis (RA) initiating biologic or targeted-synthetic (b/ts) disease-modifying antirheumatic drugs (DMARDs). The objective of our study was to evaluate the association between frailty and serious infections in a younger population of patients (<65 years old) with RA who initiated b/tsDMARDs.
methodsUsing MarketScan data, we identified new users of tumor necrosis factor inhibitors (TNFi), non-TNFi biologic DMARDs, or Janus kinase inhibitors (JAKi) between 2008 and 2019 among those with RA. Patients' baseline frailty risk score was calculated using a Claims-Based Frailty Index (≥0.2 defined as frail) 12 months prior to drug initiation. The primary outcome was time to serious infection; secondarily, we examined time-to-any infection and all-cause hospitalizations. We used Cox proportional hazards to estimate adjusted hazard ratios and 95% confidence intervals (95% CIs) and assessed the significance of interaction terms between frailty status and drug class.
resultsA total of 57,980 patients, mean (±SD) age 48.1 ± 10.1 were included; 48,139 (83%) started TNFi, 8,111 (14%) non-TNFi biologics, and 1,730 (3%) JAKi. Among these, 3,560 (6%) were categorized as frail. Frailty was associated with a 50% increased risk of serious infections (adjusted hazard ratio [95% CI] 1.5, 1.2-1.9) and 40% higher risk of inpatient admissions (1.4 [1.3-1.6]) compared with nonfrail patients among those who initiated TNFi. Frailty was also associated with a higher risk of any infection relative to nonfrail patients among those on TNFi (1.2 [1.1-1.3]) or non-TNFi (1.2 [1.0-1.4]) or JAKi (1.4 [1.0-2.0]).
conclusionFrailty is an important predictor for the risk of adverse outcomes among patients with RA treated with biologic or targeted-synthetic DMARDs.
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