Infections during tumour necrosis factor-  blocker therapy for rheumatic diseases in daily practice: a systematic retrospective study of 709 patients

Abstract

The rate of serious infections during TNF-alpha blocker treatment observed in daily practice conditions was much higher than in phase III trials evaluating TNF-alpha blockers. Serious infections are frequent in daily practice and close monitoring is required.

Infliximab treatment in patients with rheumatoid arthritis and spondyloarthropathies in one rheumatological center: two years’ drug survival

“…These data are in agreement with the results of Curtis et al who reported a 4-fold greater risk of infections during the first 6 months of infliximab treatment [40]. The most frequently occurring severe infections during infliximab treatment are pulmonary, skin, soft tissue, joint and bone infections, and also septic infections are slightly more probable in RA patients treated with biological agents than in those treated with conventional DMARDs [11][12][13]41]. Oral glucocorticoids ha ve also been reported to elevate the risk of infections in patients with RA even at a dose under 5 mg/day [36,38,39].…”

“…It is routinely used in the everyday practice when traditional DMARDs are not sufficiently effective. Although infliximab is generally safe and well tolerated, sometimes the treatment must be discontinued due to adverse events [1][2][3][6][7][8][9][10], mainly infections [11][12][13][14] and hypersensitivity reactions [14,15]. In addition, inadequate or waning efficacy complicates drug survival in infliximab-treated patients [8, 10,14,16].…”

The Safety of Anti-TNF Agents in the Elderly

“…Infections were the most frequent adverse events observed in our population, leading to temporary or permanent discontinuation of anti-TNF therapy (25 Mainly, we observed mild infections that did not even require antibiotic therapy, such as flu-like syndrome, but also pharyngotonsillitis, bronchitis, and cystitis, the latter often requiring antibiotics. The incidence of mild or moderate infections does not seem to differ from that observed in a healthy population ofthe same age.…”

Late Onset Prosthetic Hip Joint Infection in Two Patients of Rheumatoid Arthritis Treated With Etanercept

“…5 Galloway et al 6 reported that exposure to TNF blocker therapy was associated with an increased risk of joint infection in patients with RA. This risk was greatest in the first year of treatment.…”

“…5,7 Schneeweiss et al 7 demonstrated that the use of steroids doubled the rate of severe bacterial infections when compared with methotrexate therapy, independent of previous disease-modifying antirheumatic drug use (odds ratio= 2.1), and demonstrated a clear dose-response relationship. In our first patient, infection after THA occurred following the introduction of TNF-a blocker.…”