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Increased risk of coccidioidomycosis in patients treated with tumor necrosis factor alpha antagonists

Laurie Bergstrom1, David E Yocum, Neil M Ampel

  • 1University of Arizona, Tucson, 85724, USA. laurieb@arthritis.arizona.edu

Arthritis and Rheumatism
|June 10, 2004
PubMed
Abstract

Insights

Patients treated with tumor necrosis factor alpha (TNF alpha) antagonists, particularly infliximab, face an increased risk of developing coccidioidomycosis. This finding highlights a critical safety concern for inflammatory arthritis patients in endemic areas.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Immunology

Background:

  • Tumor necrosis factor alpha (TNF alpha) antagonists are used to treat inflammatory arthritis.
  • Coccidioidomycosis is a fungal infection endemic to specific regions of the United States.

Observation:

  • A study reviewed cases of coccidioidomycosis in patients receiving TNF alpha antagonist therapy.
  • Thirteen cases were identified, predominantly associated with infliximab use.

Findings:

  • Patients with inflammatory arthritis on infliximab showed a significantly higher relative risk (5.23) of developing symptomatic coccidioidomycosis compared to those on other therapies.
  • This increased risk was statistically significant (P < 0.01).

Implications:

  • Physicians should be aware of the heightened risk of coccidioidomycosis in patients treated with infliximab.
  • Monitoring and preventive strategies may be warranted for patients in endemic areas receiving TNF alpha antagonists.

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