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Infections in rheumatoid arthritis
Fabiola Atzeni1, Ignazio Francesco Masala, Manuela di Franco
1aIRCCS Galeazzi Orthopedic Institute, Milan bOrthopedic and Trauma Unit, Santissima Trinità Hospital, Cagliari cRheumatology Unit, Department of Internal Medicine and Medical Specialities, La Sapienza University of Rome, Rome dRheumatology Unit, L. Sacco University Hospital, Milan, Italy.
Current Opinion in Rheumatology
|April 20, 2017
Summary
Biological drugs used for rheumatoid arthritis (RA) are linked to serious infections, with no difference in risk between short-term or long-term use. Physicians must inform patients and manage these risks effectively.
Area of Science:
- Rheumatology
- Infectious Diseases
- Pharmacology
Background:
- Rheumatoid arthritis (RA) patients face frequent infections due to disease activity, comorbidities, and treatments.
- Conventional disease-modifying antirheumatic drugs (DMARDs) and biological drugs can increase infection risk.
- Serious infections, including tuberculosis, are a concern in RA patients on immunosuppressive therapy.
Purpose of the Study:
- To review recent advances in understanding serious infections in RA patients treated with biological drugs or conventional DMARDs.
- To focus on evidence-based studies published within the last 18 months.
- To update knowledge on the relationship between RA treatments and infection risk.
Main Methods:
- Literature review of studies published in the last 18 months.
- Analysis of evidence regarding serious infections in RA patients.
- Synthesis of findings on biological drugs and conventional DMARDs.
Main Results:
- Recent studies reinforce the association between biological drugs and serious infections in RA.
- Infection risk appears consistent regardless of short-term or long-term use of biological drugs.
- Biomarker identification for infection risk remains inconclusive, though direct drug effects on cytokines and cell activity are plausible.
Conclusions:
- Biological drugs and conventional DMARDs increase the risk of serious infections in RA patients.
- Physicians must be vigilant about infection risks and treatment complications.
- Informing patients about increased infection risk is crucial for management.