Fabiola Atzeni1, Ignazio Francesco Masala, Manuela di Franco, Piercarlo Sarzi-Puttini. 1. aIRCCS 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.
Abstract
PURPOSE OF REVIEW: The purpose of this review is to provide an update concerning recent advances in the evidence- based study of serious infections in patients with rheumatoid arthritis (RA) treated with biological drugs or conventional disease-modifying antirheumatic drugs (DMARDs), concentrating on studies published in the last 18 months. RECENT FINDINGS: New studies have further strengthened existing evidence relating the use of biological drugs to serious infections. The risk does not seem to be any different with short-term or long-term use. There is still a lack of conclusive studies identifying biomarkers, but it is plausible that the drugs have direct effects on cytokines and cell activity and then serious infections. SUMMARY: The frequent infections of patients with RA may be due to the disease itself (altered immunological function, disability, immobility, joint surgery), extra-articular manifestations or DMARDs, immunosuppressants and steroids. The use of biological drugs lead to the development of serious infections including tuberculosis. Patients should be informed of their increased risk, and physicians need to be aware of these complications and how to treat them.
PURPOSE OF REVIEW: The purpose of this review is to provide an update concerning recent advances in the evidence- based study of serious infections in patients with rheumatoid arthritis (RA) treated with biological drugs or conventional disease-modifying antirheumatic drugs (DMARDs), concentrating on studies published in the last 18 months. RECENT FINDINGS: New studies have further strengthened existing evidence relating the use of biological drugs to serious infections. The risk does not seem to be any different with short-term or long-term use. There is still a lack of conclusive studies identifying biomarkers, but it is plausible that the drugs have direct effects on cytokines and cell activity and then serious infections. SUMMARY: The frequent infections of patients with RA may be due to the disease itself (altered immunological function, disability, immobility, joint surgery), extra-articular manifestations or DMARDs, immunosuppressants and steroids. The use of biological drugs lead to the development of serious infections including tuberculosis. Patients should be informed of their increased risk, and physicians need to be aware of these complications and how to treat them.
Authors: Paloma Vela; Carlos Sanchez-Piedra; Carolina Perez-Garcia; María C Castro-Villegas; Mercedes Freire; Lourdes Mateo; Cesar Díaz-Torné; Cristina Bohorquez; Juan M Blanco-Madrigal; Inmaculada Ros-Vilamajo; Silvia Gómez; Rocio Caño; Fernando Sánchez-Alonso; Federico Díaz-González; Juan J Gómez-Reino Journal: Arthritis Res Ther Date: 2020-06-15 Impact factor: 5.156
Authors: Priyanka Iyer; Yubo Gao; Elizabeth H Field; Jeffrey R Curtis; Charles F Lynch; Mary Vaughan-Sarrazin; Namrata Singh Journal: ACR Open Rheumatol Date: 2020-11-20