Adding Denosumab to a Biologic Might Not Increase Risk for Infection

Treating patients with rheumatoid arthritis (RA) and osteoporosis often is difficult because of comorbid conditions (e.g., renal insufficiency), inconvenience, and expense. Bisphosphonates have become the mainstay for managing osteoporosis, but potential side effects, such as osteonecrosis of the jaw, esophageal carcinoma, and atypical fractures, must be considered. Teriparatide (Forteo) is expensive and must be injected daily. The biologic agent denosumab (Prolia) is another option, but studies have showed possible excess risk for cellulitis, and RA patients might be more prone to infections when two biologics are used together.

Researchers used a Medicare database to identify 5814 patients with RA who received any RA biologic therapy for 1…