Biologic agents do more than slow the progression of autoimmune forms of arthritis; they also can help you live longer, according to a new study presented recently in Berlin, at the annual congress of the European League Against Rheumatism, or EULAR.

It is already known that treating rheumatoid arthritis, or RA, can help you live longer, and that untreated RA can lower life expectancy. But this study shows a mortality benefit even over traditional disease modifying anti-rheumatic drugs, or DMARDs, such as methotrexate, hydroxychloroquine and leflunomide.  

Yet experts, including the study author, stress it is not necessarily the biologic increasing life expectancy, but better control of the disease.

“Patients with highly active rheumatoid arthritis have a shorter life expectancy than subjects from the general population with equal age and gender,” says lead study author Joachim Listing, PhD, head of the group statistics and clinical trials at the German Rheumatism Research Center in Berlin. “That means they die on average five years earlier. Patients in whom the disease is successfully controlled by disease modifying anti-rheumatic drugs – [traditional] or biologic – have, compared to those with active disease, an increased life expectancy.”

The German study looked at nearly 9,000 patients with rheumatoid arthritis. It found the mortality rate in those using biologic agents to be roughly half that of those using traditional DMARDs.

Researchers measured mortality in patient/years. Patient/years is a way of following trends in a group of people. In this case, for every 1,000 patients on an anti-TNF biologic – such as etanercept, or Enbrel; infliximab, or Remicade; and adalimumab, or Humira – there were 10.6 deaths over a one-year period. For those using the biologic rituximab – or Rituxan, a selective B-cell inhibitor – there were 12.7 deaths, and for those using a traditional DMARD, there were 20.6 deaths.

Biologic agents differ from traditional DMARDs in that they are genetically engineered to target a specific part of the immune system responsible for the inflammation seen with RA and other types of inflammatory arthritis. In addition to anti-TNFs and selective B-cell inhibitors, other biologics target interleukin-1 (anakinra, or Kineret), interleukin-6 (tocilizumab or Actemra), or work as a selective co-stimulation modulator (abatacept, or Orencia).