The use of biologic agents in patients who have rheumatoid arthritis (RA) with reactive amyloid A (AA) amyloidosis can reduce the risk of death. The use of biologics may not have a significant effect on the hemodialysis (HD)-free survival rate.
Kuroda and coworkers assessed clinical data from the records of 133 patients with an established diagnosis of reactive AA amyloidosis at the time of amyloid detection and administration of biologic agents. Survival was calculated from the date when amyloid was first demonstrated histologically or when biologic therapy was started until the time of death or to the end of 2010 for surviving patients. Patients for whom HD therapy was started were selected for inclusion only after the presence of amyloid was demonstrated.
The survival rate was significantly higher in the 53 patients treated with biologic agents (biologic group) than in the 80 patients who were not (nonbiologic group). HD therapy was started for 9 patients in the biologic group and 33 patients in the nonbiologic group; biologic therapy had a tendency for a reduced risk of initiation of HD but without statistical significance.
The authors noted that reactive AA amyloidosis is a serious and life-threatening systemic complication of RA.