Infections in patients with rheumatoid arthritis treated with biologic agents.
Joachim Listing,Anja Strangfeld,Sonja Kary,Rolf Rau,Ulrich von Hinueber,Maria Stoyanova-Scholz,Erika Gromnica-Ihle,C Antoni,P. Herzer,Jörn Kekow,Matthias Schneider,Angela Zink +11 more
Reads0
Chats0
TLDR
Patients treated with biologic agents have a higher a priori risk of infection, however, the data suggest that this risk is increased by treatment with tumor necrosis factor inhibitors.Abstract:
Objective
To estimate the incidence rates of serious and nonserious infections in patients with rheumatoid arthritis (RA) who start treatment with a biologic agent, and to compare these rates with those in patients with RA who receive conventional treatment
Methods
Patients enrolled in the German biologics register between May 2001 and September 2003 were included Treating rheumatologists assessed adverse events and serious adverse events All adverse events and serious adverse events experienced within 12 months after study entry were analyzed Propensity score methods were applied to estimate which part of a rate increase was likely to be attributable to differences in patient characteristics
Results
Data were available for 512 patients receiving etanercept, 346 patients receiving infliximab, 70 patients receiving anakinra, and 601 control patients treated with disease-modifying antirheumatic drugs The total number of adverse events per 100 patient-years was 226 (95% confidence interval [95% CI] 187–272) among patients receiving etanercept, 283 (95% CI 231–347) among patients receiving infliximab, and 68 (95% CI 50–94) among controls (P < 00001) Significant differences in the rate of serious adverse events were also observed For patients receiving etanercept, those receiving infliximab, and controls, the total numbers of serious adverse events per 100 patient-years were 64 (95% CI 45–91), 62 (95% CI 40–95), and 23 (95% CI 13–39), respectively (P = 00016) After adjusting for differences in the case patient mix, the relative risks of serious adverse events were 22 (95% CI 09–54) for patients receiving etanercept and 21 (95% CI 08–55) for patients receiving infliximab, compared with controls
Conclusion
Patients treated with biologic agents have a higher a priori risk of infection However, our data suggest that this risk is increased by treatment with tumor necrosis factor inhibitorsread more
Citations
More filters
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.
Journal ArticleDOI
Tumor necrosis factor antagonist mechanisms of action: A comprehensive review
TL;DR: The biology of T NF and related family members are discussed in the context of the potential mechanisms of action of TNF antagonists in a variety of immune-mediated inflammatory diseases.
Journal ArticleDOI
American College of Rheumatology 2008 Recommendations for the Use of Nonbiologic and Biologic Disease-Modifying Antirheumatic Drugs in Rheumatoid Arthritis
Kenneth G. Saag,Gim Gee Teng,Nivedita M. Patkar,Jeremy Anuntiyo,Catherine Finney,Jeffrey R. Curtis,Harold E. Paulus,Amy S. Mudano,Maria Pisu,Mary Elkins-Melton,Ryan C. Outman,Jeroan J. Allison,Maria Suarez Almazor,S. Louis Bridges,W. Winn Chatham,Marc C. Hochberg,Catherine H. MacLean,Ted R. Mikuls,Larry W. Moreland,James O'Dell,Anthony M. Turkiewicz,Daniel E. Furst +21 more
TL;DR: Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient.
Journal ArticleDOI
Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 1: Definitions, Diagnosis, Extra-intestinal Manifestations, Pregnancy, Cancer Surveillance, Surgery, and Ileo-anal Pouch Disorders.
Fernando Magro,Paolo Gionchetti,Rami Eliakim,Sandro Ardizzone,Alessandro Armuzzi,Manuel Barreiro-de Acosta,Johan Burisch,Krisztina Gecse,Ailsa Hart,Pieter Hindryckx,Cord Langner,Jimmy K. Limdi,Gianluca Pellino,Edyta Zagórowicz,Tim Raine,Marcus Harbord,Florian Rieder +16 more
TL;DR: This research presents a meta-analyses of Gastroenterology and Hepatology at the cellular and molecular level, which shows clear trends in the development of immune-oncology-metabolical pathways towards “clinically checkpoints”.
Journal ArticleDOI
European evidence-based Consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease.
Jean-François Rahier,Fernando Magro,Candida Abreu,Alessandro Armuzzi,Shomron Ben-Horin,Yehuda Chowers,Mario Cottone,L. de Ridder,Glen A. Doherty,Robert Ehehalt,Maria Esteve,K.H. Katsanos,Charlie W. Lees,Eithne MacMahon,Tom G. Moreels,Walter Reinisch,Herbert Tilg,Lydjie Tremblay,Gigi Veereman-Wauters,N. Viget,Yazdan Yazdanpanah,Rami Eliakim,Jean-Frederic Colombel +22 more
TL;DR: The treatment of inflammatory bowel disease has been revolutionised over the past decade by the increasing use of immunomodulators, mainly azathioprine/6-mercaptopurine and methotrexate, together with the advent of biological therapy.
References
More filters
Journal ArticleDOI
The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis.
Frank C. Arnett,Steven M. Edworthy,Daniel A. Bloch,Dennis J. McShane,James F. Fries,Norman S. Cooper,L. A. Healey,Stephen R. Kaplan,Matthew H. Liang,Harvinder S. Luthra,Thomas A. Medsger,Donald M. Mitchell,David H. Neustadt,Robert S. Pinals,Jane G. Schaller,John T. Sharp,Ronald L. Wilder,Gene G. Hunder +17 more
TL;DR: The revised criteria for the classification of rheumatoid arthritis (RA) were formulated from a computerized analysis of 262 contemporary, consecutively studied patients with RA and 262 control subjects with rheumatic diseases other than RA (non-RA).
Journal Article
Revised criteria for the classification of rheumatoid arthritis.
TL;DR: The Bulletin on the Rheumatic Diseases has published all of the classification criteria for the rheumatic diseases to date, and these new revised classified criteria for rheumatoid arthritis are very important as they should provide understanding of the possibly changing face of rheumatism.
Journal ArticleDOI
Revised criteria for the classification of rheumatoid arthritis.
TL;DR: The Bulletin on the Rheumatic Diseases has published all of the classification criteria for rheumatic diseases to date as mentioned in this paper, and these new revised classification criteria are very important as they should provide understanding of the possibly changing face of rheumatoid arthritis.
Journal ArticleDOI
Modified disease activity scores that include twenty-eight-joint counts : development and validation in a prospective longitudinal study of patients with rheumatoid arthritis
M.L.L. Prevoo,M.A. van 't Hof,H.H. Kuper,M.A. van Leeuwen,L. B. A. Van De Putte,P.L.C.M. van Riel +5 more
TL;DR: The Modified DAS that included 28-joint counts were able to discriminate between high and low disease activity (as indicated by clinical decisions of rheumatologists) and are as valid as disease activity scores that include more comprehensive joint counts.
Journal ArticleDOI
Propensity score methods for bias reduction in the comparison of a treatment to a non‐randomized control group
TL;DR: The propensity score, defined as the conditional probability of being treated given the covariates, can be used to balance the variance of covariates in the two groups, and therefore reduce bias as mentioned in this paper.