Lower Rheumatoid Arthritis Disease Activity Associated With Fewer Serious Infections

bacteria, clostridium difficile
bacteria, clostridium difficile
Attaining low RA disease activity may reduce risk for serious infections.

Lower rheumatoid arthritis (RA) disease activity may be associated with a reduced risk for serious infection, according to a retrospective analysis published in Arthritis Care & Research.1

Patients with RA have an increased risk for infection, as well as increased mortality which may be due to this greater risk of infection compared with the general population.2-8 However, the relationship between the level of RA disease activity and the risk of infection had not previously been established.

Therefore, using data from a US RA registry, researchers compared the incidence rate of serious infections in patients with RA achieving sustained remission with RA patients who have sustained low disease activity (LDA).1

In addition, they examined the incidence of serious infections in patients with RA with LDA and patients with RA with moderate to high disease activity.

The researchers found that the adjusted rate of serious infections was 69% higher in patients with RA who attained LDA compared with patients in sustained remission. In addition, they found that in absolute terms, remission and LDA were associated with a lower rate of serious infections (1 to 2 cases per 100 patient-years) compared with patients with moderate to high RA disease activity.

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“Overall, these findings indicate that lower RA disease activity, even between the contrasts of remission and LDA, was associated with a lower risk of serious infections” concluded the investigators.1

They hope that these findings will encourage patients and clinicians to make remission their goal rather than only LDA in patients with RA, which may lead to a reduced risk for serious infections.


  1. Accortt NA, Lesperance T, Liu M, et al. Impact of sustained remission on the risk of serious infection in patients with rheumatoid arthritis [published online March 11, 2018]. Arthritis Care Res. doi:10.1002/acr.23426
  2. Doran MF, Crowson CS, Pond GR, O’Fallon WM, Gabriel SE. Frequency of infection in patients with rheumatoid arthritis compared with controls: a population-based study.
  3. Arthritis Rheum 2002;46:2287-2293.
  4. Allebeck P. Increased mortality in rheumatoid arthritis. Scand J Rheumatol 1982;11:81-86.
  5. Mutru O, Laakso M, Isomaki H, Koota K. Ten year mortality and causes of death in patients with rheumatoid arthritis. Br Med J (Clin Res Ed) 1985;290:1797-1799.
  6. Myllykangas-Luosujarvi R, Aho K, Kautiainen H, Isomaki H. Shortening of life span and causes of excess mortality in a population-based series of subjects with rheumatoid arthritis. Clin Exp Rheumatol 1995;13:149-153.
  7. Riise T, Jacobsen BK, Gran JT, Haga HJ, Arnesen E. Total mortality is increased in rheumatoid arthritis: a 17-year prospective study. Clin Rheumatol 2001;20:123-127.
  8. Sokka T, Abelson B, Pincus T. Mortality in rheumatoid arthritis: 2008 update. Clin Exp Rheumatol 2008;Suppl 51:S35-S61.
  9. Thomas E, Symmons DP, Brewster DH, Black RJ, Macfarlane GJ. National study of cause-specific mortality in rheumatoid arthritis, juvenile chronic arthritis, and other rheumatic conditions: a 20 year followup study. J Rheumatol 2003;30:958-965.

This article originally appeared on Rheumatology Advisor