Incidence of infection other than tuberculosis in patients with autoimmune rheumatic diseases treated with bDMARDs: a real-time clinical experience from India

Chandrashekara, S; Shobha, Vineeta; Rao, Vijay; Desai, Anant; Jois, Ramesh; Dharmanand, BG; Kumar, Sharath; Kumar, Pradeep; Dharmapalaiah, Chethana; Mahendranath, Kurugodu M.; Prasad, Shiva; Daware, Manisha; Singh, Yogesh Preet; Karjigi, Uma; Nagaraj, Sujay; Anupama, K. R.

doi:10.1007/s00296-019-04245-4

Cited by 7 publications

(7 citation statements)

References 23 publications

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“…When weighing the risks and advantages of using biologics for a patient with systemic autoimmune diseases, it is obvious that the benefits must outweigh the risks [6]. The influence of medication-induced imbalance on the immune system, cofactors, and intermediate factors is what leads to adverse drug reactions [7].…”

Section: Editorialmentioning

confidence: 99%

“…Diabetes mellitus had the greatest infection incidence rate among these disorders. [7]. Various studies states that the existence of chronic pulmonary comorbidity, increasing age, a mean MTX dose of >8 mg/week, a higher mean C-Reactive Protein, and a mean oral Prednisolone dosage of >10 mg/day have been found as independent risk factors for infections [9].…”

Section: Editorialmentioning

confidence: 99%

“…One study claimed that, if young patients on 7.5 mg/day of Prednisone were able to stop taking Glucocorticoids after starting an anti-TNF treatment, the total incidence of hospitalized infections would decrease as a result [10]. According to Yun et al, using ETN, IFN in RA patients who had previously been exposed to a biologic drug is associated with a higher one-year risk of serious infection than using Abatacept [7]. Curtis et al found that, only individuals who had been exposed to INF showed a substantial increase in severe infections within the first six months after starting anti-TNF medication compared to those who had just taken MTX [11].…”

Section: Hospitalized Infectionsmentioning

confidence: 99%

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Risk of Infections in patients using Anti-TNF Medications: A Literature Review

Ram¹

2022

Journal For International Medical Graduates

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The paradigm for treating chronic Autoimmune Rheumatic Disorders (ARDs) has changed thanks to biologic disease-modifying anti-rheumatic medicines (bDMARDs), however one of its most significant adverse effects is an elevated risk of infections. The current research assessed the incidence, severity, and type of infections in ARD patients on bDMARDs. Disease activity is interwoven with both infectious and chronic inflammatory diseases. Infections are more likely to occur in people with Rheumatoid Arthritis as high disease activity actually reflects persistent inflammation, which may weaken immunity and encourage the spread of various types of infections. Those with RA had an adjusted risk of being hospitalized with an infection that was two times greater when age, sex, concomitant conditions, and prescription medication use were taken into consideration. The risk of mycobacterial infection appears to be lowest with Etanercept (ETN) and highest with Adalimumab (ADA) and Infliximab (INF). Centers of Disease Control and Prevention (CDC) recommends administration of shingles vaccine to all individuals who are on Tumor Necrosis Factor (TNF) inhibitors to prevent Skin and Soft Tissue Infections (SSTI).

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Section: Editorialmentioning

confidence: 99%

Section: Editorialmentioning

confidence: 99%

Section: Hospitalized Infectionsmentioning

confidence: 99%

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Risk of Infections in patients using Anti-TNF Medications: A Literature Review

Ram¹

2022

Journal For International Medical Graduates

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“…Oral herpes simplex or varicella zoster virus infections were found to manifest during treatment with belatacept, etanercept, infliximab, and anakinra, and were also described in a larger report dealing with patients on a variety of biologic agents. 33,34 These infections were mainly self-limiting, but at least in one case progressed to disseminated varicella zoster virus infection. 35 This case manifested in the mandibular division of the trigeminal nerve as buccal mucosa ulceration.…”

Section: Oral Infectionsmentioning

confidence: 99%

World Workshop on Oral Medicine VII: Oral adverse effects to biologic agents in patients with inflammatory disorders. A scoping review

France

Yogarajah

Gueiros

et al. 2022

J Oral Pathology Medicine

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Background Biologic agents are rapidly emerging as an effective therapy to treat autoimmune and other chronic diseases. The use of these agents is poorly characterized, resulting in a lack of guidance for dental practitioners. Case reports of oral adverse events have begun to emerge. However, their scope and frequency have not been summarized and analysed to date. The objective of this review was to characterize the literature on oral adverse effects associated with biological therapy when used for autoimmune and inflammatory disorders. Methods This review was developed in accordance with scoping review recommendations. Search strategies were developed and employed for six databases. Studies were selected using a systematic search process but with broad inclusion of study types given the paucity of information available. Reports of oral adverse events were analysed descriptively according to agent, mechanism of action, underlying disease, and oral adverse effect observed. Results Our search returned 2080 articles and 51 met our inclusion criteria, of which most were case reports. The most frequent adverse effects included angioedema, oral lichenoid lesions, osteonecrosis of the jaw, and oral infections. There were also cases of oral malignancies associated with use of biologic agents. Less common effects such as pigmentation were also described. Conclusions Oral adverse events have been reported in patients on biologic therapy, albeit in small numbers to date. This limits the generalizability of these results, which should not be used to generate a clinical guideline as they are based primarily on case reports. However, this study presents the first review characterizing the adverse effects observed. Large multi‐center studies will be necessary to further define the oral and dental complications caused by biologic agents.

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“…However, disease remission remains uncommon [4]. Furthermore, therapies targeting different aspects of the immune response render patients more susceptible to infection [5]. In light of these challenges, approaches that focus on other components of joint inflammation have been proposed as potential solutions [4].…”

Section: Introductionmentioning

confidence: 99%

Differential Expression Profiles of the Transcriptome and miRNA Interactome in Synovial Fibroblasts of Rheumatoid Arthritis Revealed by Next Generation Sequencing

Tseng

Tsai

et al. 2019

Diagnostics

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Using next-generation sequencing to decipher the molecular mechanisms underlying aberrant rheumatoid arthritis synovial fibroblasts (RASF) activation, we performed transcriptome-wide RNA-seq and small RNA-seq on synovial fibroblasts from rheumatoid arthritis (RA) subject and normal donor. Differential expression of mRNA and miRNA was integrated with interaction analysis, functional annotation, regulatory network mapping and experimentally verified miRNA–target interaction data, further validated with microarray expression profiles. In this study, 3049 upregulated mRNA and 3552 downregulated mRNA, together with 50 upregulated miRNA and 35 downregulated miRNA in RASF were identified. Interaction analysis highlighted contribution of miRNA to altered transcriptome. Functional annotation revealed metabolic deregulation and oncogenic signatures of RASF. Regulatory network mapping identified downregulated FOXO1 as master transcription factor resulting in altered transcriptome of RASF. Differential expression in three miRNA and corresponding targets (hsa-miR-31-5p:WASF3, hsa-miR-132-3p:RB1, hsa-miR-29c-3p:COL1A1) were also validated. The interactions of these three miRNA–target genes were experimentally validated with past literature. Our transcriptomic and miRNA interactomic investigation identified gene signatures associated with RASF and revealed the involvement of transcription factors and miRNA in an altered transcriptome. These findings help facilitate our understanding of RA with the hope of serving as a springboard for further discoveries relating to the disease.

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Incidence of infection other than tuberculosis in patients with autoimmune rheumatic diseases treated with bDMARDs: a real-time clinical experience from India

Cited by 7 publications

References 23 publications

Risk of Infections in patients using Anti-TNF Medications: A Literature Review

Risk of Infections in patients using Anti-TNF Medications: A Literature Review

World Workshop on Oral Medicine VII: Oral adverse effects to biologic agents in patients with inflammatory disorders. A scoping review

Differential Expression Profiles of the Transcriptome and miRNA Interactome in Synovial Fibroblasts of Rheumatoid Arthritis Revealed by Next Generation Sequencing

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