The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis (BSRBR-RA) study has been central in understanding the long-term safety and effectiveness of biologic, biosimilar and JAKi therapies for rheumatoid arthritis (RA). Over the past two decades, this observational cohort study has tracked the progress of over 30,000 participants in the UK, collecting data from both clinicians and participants regarding their treatments for RA and any new illnesses or side effects that are experienced.  

Long-term safety profile of biologic therapies

One of the most significant impacts of the BSRBR-RA study is its contribution to the long-term safety profile of biologic therapies. By monitoring adverse events and treatment outcomes over a number of years, the study has helped to identify potential risks and benefits associated with these therapies. This has enabled healthcare professionals to make more informed decisions when prescribing treatments, ultimately improving patient care. 

The research shows…

Dr Kearsley Fleet’s analysis in 2024 made excellent use of this large long-term dataset. It was already known that biologic treatments can raise the risk of serious infections, including tuberculosis, but Dr Kearsley-Fleet’s work aimed to find out if the number of different biologics a patient had tried affected their risk of infections. She analysed data from over 33,000 treatment courses in the BSRBR-RA and found that the overall risk of serious infections did not seem to increase depending on how many different biologics a patient had already tried. When it came to tuberculosis, cases were mostly seen with the first few lines of treatment, and infections were less common after 2009, likely due to improved screening methods.

These findings suggest that patients who need to switch from one biologic treatment to another can do so without significantly increasing their risk of serious infections. This supports the safe and flexible use of different biologic drugs in treating RA. However, special attention is still needed for tuberculosis risk, especially when starting biologics for the first time.  

Short summaries of all research outputs are on the BSRBR-RA website. Please feel free to explore these summaries to discover more about the long-term impact the BSRBR-RA has had on research outcomes! 

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Contact us – biologics.register@manchester.ac.uk

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