Biologics: An Important Piece of Patient Advice

Kevin Deane, MD, PhD


May 26, 2016

The Majority of Patients Do Not Store Their Biologic Disease-Modifying Antirheumatic Drugs Within the Recommended Temperature Range

Vlieland ND, Gardarsdottir H, Bouvy ML, Egberts TC, van den Bemt BJ
Rheumatology (Oxford). 2016;55:704-709

Study Summary

In this study, Vlieland and colleagues evaluated the temperatures at which patients with rheumatic diseases stored their biologic disease-modifying antirheumatic drugs (DMARDs). They did this by providing patients with an electronic temperature logger.

Of the 293 study participants given a temperature logger, 255 (87.0%) returned their logger to the pharmacy. Of these 255 participants, only 17 (6.7%) had stored their medication within the recommended temperature range. Of those who did not, 24.3% stored their medication for more than 2 hours outside of the recommended range.

The authors did not evaluate the effect of these storage conditions on the biologic activity of the medication but speculated that storing these medications outside of the recommended temperature range may adversely affect their efficacy.


Rheumatologists are constantly monitoring disease activity and drug efficacy in their patients. They think about such things as the underlying biology of disease and whether the drug used is effectively targeting this. They also wonder about proper dosing and whether patients are compliant with the prescribed therapy.

This relatively straightforward study raises an important point in rheumatologic patient care: Are patients storing their medication correctly? What if, for example, a tumor necrosis factor antagonist is just the right biologic agent for a patient's disease, but the way the patient stores the drug leads to drug breakdown and suboptimal efficacy? Rheumatologists may not even be aware of this and change medications, when all that was needed was better instruction on storage.

Certainly more research is needed on how storage conditions affect biologic and nonbiologic DMARD efficacy and stability. As a start, storing these medications at their proper temperature range shouldn't hurt. However, rheumatologists should not be the only ones helping out in this area—pharmacists and others should lend a hand too!



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