What question did this study set out to answer?

Evaluate the safety outcomes of synthetic and biological DMARDs in rheumatoid arthritis to inform updated guidelines.

April 11, 2026Open Access

Safety of synthetic and biological DMARDs: a systematic literature review informing the 2025 update of the EULAR recommendations for the management of rheumatoid arthritis

Key Points

Evaluate the safety outcomes of synthetic and biological DMARDs in rheumatoid arthritis to inform updated guidelines.
Conducted a systematic literature review (SLR) on safety outcomes of DMARDs.
Analyzed observational studies focusing on malignancy, thromboembolic, and cardiovascular events.
Utilized claims databases for evaluating safety outcomes while noting methodological limitations.
Identified an increase in studies on safety outcomes, particularly for JAK inhibitors.
Noted a lack of recent studies focusing on glucocorticoid safety outcomes.
Revealed important methodological limitations in many safety evaluations using claims databases.

Abstract

There has been a notable increase in studies evaluating safety outcomes, with the majority of these being observational studies focusing primarily on malignancy, thromboembolic, and cardiovascular events, with most studies pertaining to JAKi safety. A substantial proportion of studies in this SLR relied on claims databases to evaluate safety outcomes, a practice that carries important methodological limitations for safety research. Surprisingly, not many studies looked into glucocorticoid safety outcomes over the past 3 years. This SLR, along with the SLR on efficacy of DMARDs, informed the 2025 update of the EULAR recommendations for management of RA with synthetic and biological DMARDs.

Read Full Paperexternally

Mark Helpful

Bookmark

Relay

View Full Paper