A NEW study has provided evidence that prolonged use of infliximab a biologic commonly used to treat rheumatoid arthritis (RA), may help protect against cervical spine deformity in patients with RA.
Over the past several decades, the incidence of cervical spine surgery in RA patients has decreased, likely due to the availability of effective disease-modifying treatments. While infliximab is known to prevent joint damage in the hands and feet, its role in protecting the cervical spine had been uncertain, until now.
Researchers analysed data from the BeSt Trial, focusing on 272 patients with early RA over a 10-year follow-up period. Cervical spine deformities, specifically atlantoaxial subluxation (AAS) and subaxial subluxation (SAS), were assessed via X-ray imaging at the 5-year and 10-year marks. The team found that 40% of patients showed some form of cervical spine deformity during the study.
However, each additional year of infliximab use was associated with an 11% reduction in the odds of developing cervical spine deformity (OR: 0.89; 95% CI: 0.81 to 0.98). This association was independent of disease activity, as mediation analysis revealed that changes in the Disease Activity Score (DAS44) did not influence the outcome.
The findings suggest that infliximab may offer direct protective benefits for the cervical spine, beyond its anti-inflammatory effects elsewhere in the body.
The authors highlighted the importance of weighing the long-term benefits of infliximab against its known risks when considering prolonged use in patients with RA.
Aleksandra Zurowska, EMJ
Reference
Lebouille-Veldman AB et al. Infliximab use and cervical spine deformity in patients with rheumatoid arthritis. RMD Open. 2025;11:e005237.
