Related Experiment Video

Updated: May 23, 2025

Knee Arthrocentesis in Adults

Knee Arthrocentesis in Adults

Published on: February 25, 2022

Longitudinal risk of serious infections in patients with inflammatory arthritis on immunomodulating therapy compared

Ingrid Egeland Christensen^1,2, Siri Lillegraven¹, Joseph Sexton¹

¹Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.

Rheumatology Advances in Practice

|March 10, 2025

Abstract

Objectives:

To compare the risk of serious infection across time cohorts in patients with inflammatory arthritis (IA) initiating their first biologic/targeted synthetic DMARD (b/tsDMARD), to that of the general population. Secondarily, to compare the development in infection risk during treatment across diagnoses and examine risk dynamics during the course of b/tsDMARD treatment.

Methods:

Patients with IA starting their first b/tsDMARD were included from the prospective NOR-DMARD study. Controls were randomly drawn from the general population. Cox regressions were used to compare the 12-month risk of serious infections across three time cohorts following initiation (2009-2011, 2012-2014, 2015-2018) and risk during the course of treatment at 6-month intervals up to 24 months.

Results:

A total of 4309 patients (RA, 1581; PsA, 1032; SpA, 1696) and 86 640 controls were included. From 2009 through 2018, 51 serious infections occurred during the first year of b/tsDMARD treatment in RA patients [hazard ratio (HR) 2.42 (95% CI 1.83, 3.21)] compared with controls and 52 serious infections were observed in patients with PsA/SpA [HR 1.91 (95% CI 1.44, 2.52)]. There were no significant differences in 12-month risk of serious infections during b/tsDMARD exposure between time cohorts. PsA/SpA patients had a consistently lower risk of serious infection compared with RA patients. The risk of serious infections did not change during the treatment course.

Conclusion:

Patients with IA starting their first b/tsDMARD between 2009 and 2018 had a consistently higher 12-month risk of serious infection compared with controls. No change in the risk of serious infection across time cohorts of b/tsDMARD initiation was observed, nor during the treatment course.

Keywords:

bDMARD biologics psoriatic arthritis rheumatoid arthritis serious infection spondyloarthritis

More Related Videos

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials

A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials

Published on: March 3, 2023

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Preliminary Study on Acupuncture Combined with Grain-sized Moxibustion for Treating Rheumatoid Arthritis with Finger Joint Pain

Published on: May 16, 2025

Related Concept Videos

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...

T Cell Types and Functions

T Cell Types and Functions

When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...

Factors Affecting the Risk of Infection

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...

Pulmonary Tuberculosis I

Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...

Inflammatory Bowel Disease IV: Pharmacological Management

Inflammatory Bowel Disease IV: Pharmacological Management

Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...

Keywords:

bDMARD biologics psoriatic arthritis rheumatoid arthritis serious infection spondyloarthritis

Articles linked to this work by shared authors, journal, and citation graph.

Waiting time and mortality after hip fracture: findings from a large single-center cohort study.

European journal of trauma and emergency surgery : official publication of the European Trauma Society·2026

Comorbidity and mortality in adults with juvenile idiopathic arthritis: a nationwide Norwegian register-based matched cohort study.

Rheumatology (Oxford, England)·2026

Preoperative Anxiety and/or Depression as a Predictor of Patient‑Reported Outcomes After Total Ankle Arthroplasty.

Foot & ankle international·2026

Cost-effectiveness of herpes zoster vaccination in patients with rheumatoid arthritis.

Rheumatology (Oxford, England)·2026

A self-management app in a digital treat-to-target gout-care approach: the ReMonit Gout feasibility study.

Scandinavian journal of rheumatology·2026

Impact of cardiometabolic comorbidities on clinical characteristics, prescription patterns and retention rate of first b/tsDMARD treatment in 5299 European real-world patients with psoriatic arthritis.

RMD open·2026

See all related articles