Adverse drug reactions during treatment with biologic and target-specific medications among patients with rheumatoid arthritis
Bulgarian Medical Journal, 2025, 19(1), 11-18.
S. Neycheva1, E. Naseva2,3
1 Department of Rheumatology, Military Medical Academy, MHAT – Sofia
2 Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University – Sofia
3 Medical Faculty, Sofi a University Sv. Kliment Ohridski – Sofia
Abstract. The development and introduction of biologic and target-specifi c agents in clinical practice provide signifi cant therapeutic opportunities for patients with infl ammatory joint diseases, including those with seropositive rheumatoid arthritis. Aggressive and timely treatment of rheumatoid arthritis in its early stages is associated with better disease control, prevention of joint destruction, signifi cant impact on prognosis, and reduced mortality. These medication groups are crucial for patients with high disease activity, associated with poor prognostic factors and early joint destruction. However, in real clinical practice, more than 50% of the therapeutic courses with biologics and target-specifi c medications are interrupted for various reasons, despite their good therapeutic eff ects, which has signifi cant medical, and resulting socioeconomic consequences as well. The goal of this overview is to raise the awareness about the most common reasons for the interruption of biologic and target-specifi c treatment. Adequate assessment of new patient complaints and prescribed medication will help prevent unjustifi ed treatment discontinuation or switching from one agent to another.
Key words: biologic, Janus kinase inhibitors, treatment, rheumatoid arthritis
Address for correspondence: Stefka Neycheva, MD, Military Medical Academy, MHAT – Sofia, 3 Sv. Georgi Sofiyski, St., Bg – 1606 Sofia, e-mail: