Opportunistic infections in rheumatoid arthritis patients exposed to biologic therapy: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis

Abstract

The overall rate of OI was not significantly different between drug classes; however, a subtle difference in the pattern of OI was seen between the cohorts. Patient factors such as age, gender and comorbidity were the most important predictors of OI.

The Safety Profile of Tumor Necrosis Factor Inhibitors in Ankylosing Spondylitis: Are TNF Inhibitors Safer Than We Thought?

“…In the BSRBR-RA registry (British Society for Rheumatology Biologics Register of RA patients), incidence of OI was 1.34/1000 pyrs. 46 A similar incidence (though across all indications for TNF inhibitors) was reported in French Registry of Infections and Lymphoma in Patients Treated With TNF-α Antagonists: 1.52/1000 pyrs. 47 This study also demonstrated a higher odds of OI for patients receiving monoclonal antibody treatment than ETN in the case-control analysis (IFX: OR, 17.6; 95%CI, 4.3-72.9; ADA: OR, 10.28; 95%CI, 2.35-44.94) but with no statistically significant difference in the incidence.…”

“…Low incidence of OI after TNF inhibitors was calculated also from other biologic registries. In the BSRBR‐RA registry (British Society for Rheumatology Biologics Register of RA patients), incidence of OI was 1.34/1000 pyrs . A similar incidence (though across all indications for TNF inhibitors) was reported in French Registry of Infections and Lymphoma in Patients Treated With TNF‐α Antagonists: 1.52/1000 pyrs .…”

“…Authors suggest the same mechanisms as those explaining the difference in the risk of TB may cause the difference in other OIs. The most common OIs after TNF inhibitors in both registries were herpes zoster, pneumocystosis, and legionellosis . Herpes zoster is not only the most common OI after TNF inhibitors but also seems to be associated with increased occurrence after TNF inhibitors.…”

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

“…TNF-α is a vital cytokine mediating host immune response [227]. Inhibition of TNF leads to a significant decrease of the inflammatory response, and this approach is used in therapy of autoimmune conditions, most effectively in RA, juvenile idiopathic arthritis, PsA, Psoriasis (PsO), Spondyloarthritis (SpA) and inflammatory bowel disease [228].…”

Pneumocystis jirovecipneumonia in a patient taking Benepali for rheumatoid arthritis

“…Updated data from the British Society for Rheumatology Biologics Register for rheumatoid arthritis showed the incidence rate of opportunistic infections was low at 1.33 cases per 1000 patient years 8. The authors looked at 19 162 patients and included patients who were either on anti-TNF therapy, rituximab or tocilizumab.…”