A COMPREHENSIVE study has shed light on the infection risks faced by patients with ankylosing spondylitis (AS) undergoing biologic therapies. Leveraging data from the Korean College of Rheumatology BIOlogics (KOBIO) registry, researchers conducted a detailed analysis of 2,129 AS patients, tracking infection incidences and associated risk factors over 7,107.67 person-years (PY) of follow-up.
The study found an overall infection rate of 39 events per 1,000 PY. Respiratory tract infections emerged as the most frequent, accounting for 25.89 events per 1,000 PY, followed by herpes zoster (6.13 events per 1,000 PY). These findings underscore the importance of monitoring infection risks in AS patients on biologics, given their potential susceptibility to infections due to immune system modulation.
Significant risk factors for infection included age, ischemic heart disease, complicated diabetes, chronic kidney disease, and peripheral arthritis. Notably, male sex was identified as a protective factor, with men less likely to experience infections than their female counterparts. These insights highlight the need for tailored risk assessments, especially for patients with underlying comorbidities.
Researchers also emphasised that respiratory infections, a leading cause of hospitalisations and complications in biologics-treated patients, require careful management. Herpes zoster, while less common, remains a notable concern due to its debilitating symptoms, particularly in patients with compromised immune systems.
This study provides crucial real-world evidence about the risks associated with biologic therapies, helping clinicians balance treatment efficacy with patient safety. By identifying high-risk groups, healthcare providers can implement targeted interventions, such as vaccination and vigilant infection monitoring, to minimise complications and improve patient outcomes.
Future studies are anticipated to explore preventive measures and optimise treatment protocols to ensure both efficacy and safety for AS patients globally.
Aleksandra Zurowska, EMJ
Reference
Ko MK, Moon SJ. Incidence and risk of infections in patients with ankylosing spondylitis receiving biologic therapies: A prospective observational study using the KOBIO registry. J Rheumatol. 2025;DOI: 10.3899/jrheum.2024-0443.
