Francis S. W. Zih, BSc, Research Associate and Mary-Ann Fitzcharles, MB, ChB, FRCP(C), Associate Professor, Division of Rheumatology and McGill-MGH Pain Centre, McGill University and McGill University Health Centre, Montreal, QC.
The inflammatory polyarthritides take a huge toll on the well-being of an individual. The ability to specifically target inflammatory molecules with the new "biologic" treatments has been an outstanding laboratory development that has rapidly entered the clinical domain. Early experience in the use of these costly agents has shown an excellent clinical response with both alleviation of symptoms and slowing of disease progression. There is, however, concern regarding the emergence of adverse effects. The side effect of both chronic and bacterial infections, likely more prevalent in the elderly, requires caution and meticulous patient care. Until more is known about the long-term use regarding both continued efficacy and side effects, these treatments currently should be offered to patients with the most severe and poorly responsive disease.
Key words: inflammatory arthritis, disease modifiers, biologics, infectious complications.