Safety of new biologic therapies in rheumatoid arthritis

The common side effects associated with the use of TNF inhibitors are mild, well tolerated, self-limiting, and seldom enough of a nuisance to warrant discontinuation. The benefit-to-risk ratio for the anticytokine therapies appears to be very favorable for patients with aggressive RA. Serious and potentially life threatening adverse events are rare, even in the postmarketing era. As many of these serious toxicities occur at rates of < 1 case per 1,000 patient years of TNF inhibitor use, it appears that proper patient selection and prevention measures may limit this risk further.