Journal ArticleDOI
Drug-specific risk of non-tuberculosis opportunistic infections in patients receiving anti-TNF therapy reported to the 3-year prospective French RATIO registry
Dominique Salmon-Ceron,Florence Tubach,Olivier Lortholary,Olivier Chosidow,Stéphane Bretagne,Nathalie Nicolas,E Cuillerier,Bruno Fautrel,Christian Michelet,Jacques Morel,Xavier Puéchal,D. Wendling,Marc Lémann,Philippe Ravaud,Xavier Mariette +14 more
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TLDR
Various and severe OIs, especially those with intracellular micro-organisms, may develop in patients receiving anti-TNF treatment and steroid use >10 mg/day are independently associated with OI.Abstract:
Background Anti-tumour necrosis factor (TNF) therapy may be associated with opportunistic infections (OIs). Objective To describe the spectrum of non-tuberculosis OIs associated with anti-TNF therapy and identify their risk factors. Methods A 3-year national French registry (RATIO) collected all cases of OI in patients receiving anti-TNF treatment for any indication in France. A case–control study was performed with three controls treated with anti-TNF agents per case, matched for gender and underlying inflammatory disease. Results 45 cases were collected of non-TB OIs in 43 patients receiving infliximab (n=29), adalimumab (n=10) or etanercept (n=4) for rheumatoid arthritis (n=26), spondyloarthritides (n=3), inflammatory colitis (n=8), psoriasis (n=1) or other conditions (n=5). One-third (33%) of OIs were bacterial (4 listeriosis, 4 nocardiosis, 4 atypical mycobacteriosis, 3 non-typhoid salmonellosis), 40% were viral (8 severe herpes zoster, 3 varicella, 3 extensive herpes simplex, 4 disseminated cytomegalovirus infections), 22% were fungal (5 pneumocystosis, 3 invasive aspergillosis, 2 cryptococcosis) and 4% were parasitic (2 leishmaniasis). Ten patients (23%) required admission to the intensive care unit, and four patients (9%) died. Risk factors for OIs were treatment with infliximab (OR=17.6 (95% CI 4.3 - 72.9); p 10 mg/day or intravenous boluses during the previous year (OR=6.3 (2.0 to 20.0); p=0.002). Conclusion Various and severe OIs, especially those with intracellular micro-organisms, may develop in patients receiving anti-TNF treatment. Monoclonal anti-TNF antibody rather than soluble TNF receptor therapy and steroid use >10 mg/day are independently associated with OI.read more
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Journal ArticleDOI
Risk of Serious and Opportunistic Infections Associated With Treatment of Inflammatory Bowel Diseases.
Julien Kirchgesner,Magali Lemaitre,Fabrice Carrat,Mahmoud Zureik,Franck Carbonnel,Rosemary Dray-Spira +5 more
TL;DR: Heterogeneity in risks of serious and opportunistic infections in patients treated with immune-suppressive regimens should be carefully considered and weighed against potential benefits for IBD treatment in patient management.
Journal ArticleDOI
Cytokines as Therapeutic Targets in Rheumatoid Arthritis and Other Inflammatory Diseases
TL;DR: The key efficacy and safety trials for currently approved treatments in rheumatoid arthritis are provided and the major lessons learned from a decade of use in clinical practice are reviewed, focusing mainly on anti-TNF and anti-interleukin (IL)-6 agents.
Journal ArticleDOI
Risk of malignancies using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis.
Stefanos Bonovas,Silvia Minozzi,Theodore Lytras,Marien González-Lorenzo,Valentina Pecoraro,Silvia Colombo,Ilaria Polloni,Lorenzo Moja,Michela Cinquini,Valentina Marino,Delia Goletti,Andrea Matucci,Giuliano Tocci,Giuseppe Milano,Raffaele Scarpa,Fabrizio Cantini +15 more
TL;DR: A systematic review and meta-analysis of published randomized studies found statistically significant increases in the occurrence of any infections, serious infections, and tuberculosis associated with anti-TNF drug use, while the data for opportunistic infections were scarce.
Journal ArticleDOI
Association Between the Initiation of Anti–Tumor Necrosis Factor Therapy and the Risk of Herpes Zoster
Kevin L. Winthrop,John W. Baddley,Lang Chen,Liyan Liu,Carlos G. Grijalva,Elizabeth Delzell,Timothy Beukelman,Nivedita M. Patkar,Fenglong Xie,Kenneth G. Saag,Lisa J. Herrinton,Daniel H. Solomon,James D. Lewis,Jeffrey R. Curtis +13 more
TL;DR: Among patients with RA and other inflammatory diseases, those who initiated anti-TNF therapies were not at higher risk of herpes zoster compared with patients who initiated nonbiologic treatment regimens.
Journal ArticleDOI
Tuberculosis and other opportunistic infections in tofacitinib-treated patients with rheumatoid arthritis
Kevin L. Winthrop,Sung Hwan Park,Ahmet Gül,Mario H. Cardiel,Juan J. Gomez-Reino,Yoshiya Tanaka,Kenneth Kwok,Tatjana Lukic,E. Mortensen,D. Ponce de Leon,R. Riese,Hernan Valdez +11 more
TL;DR: Tuberculosis was the most common OI reported but was rare in regions of low and medium TB incidence, and patients who screen positive for latent TB can be treated with isoniazid during tofacitinib therapy.
References
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Journal ArticleDOI
Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent
Joseph Keane,Sharon K. Gershon,Robert P. Wise,Elizabeth Mirabile-Levens,John Kasznica,William D. Schwieterman,Jeffrey Siegel,M. Miles Braun +7 more
TL;DR: Infliximab is a humanized antibody against tumor necrosis factor α (TNF-α) that is used in the treatment of Crohn's disease and rheumatoid arthritis but there is no direct evidence of a protective role of TNF- α in patients with tuberculosis.
Journal ArticleDOI
Anti-TNF Antibody Therapy in Rheumatoid Arthritis and the Risk of Serious Infections and Malignancies: Systematic Review and Meta-analysis of Rare Harmful Effects in Randomized Controlled Trials
Tim Bongartz,Alex J. Sutton,Michael J. Sweeting,Iain Buchan,Eric L. Matteson,Victor M. Montori +5 more
TL;DR: There is evidence of an increased risk of serious infections and a dose-dependent increasedrisk of malignancies in patients with rheumatoid arthritis treated with anti-TNF antibody therapy.
DatasetDOI
Guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America.
TL;DR: The most recent version of the guidelines for the prevention and treatment of opportunistic infections (OI) in HIV-infected adults and adolescents was published in 2002 and 2004, respectively as mentioned in this paper.
Journal ArticleDOI
Rates of serious infection, including site-specific and bacterial intracellular infection, in rheumatoid arthritis patients receiving anti-tumor necrosis factor therapy: results from the British Society for Rheumatology Biologics Register.
TL;DR: In patients with active RA, anti-TNF therapy was not associated with increased risk of overall serious infection compared with DMARD treatment, after adjustment for baseline risk, but the rate of serious skin and soft tissue infections was increased, suggesting an important physiologic role of TNF in host defense in the skin andsoft tissues beyond that in other tissues.