scholarly journals E59 Immunoglobulin Levels in Patients with Rheumatoid Arthritis Receiving Rituximab. Is there any Correlation with Increased Risk of Infection?

Rheumatology ◽  
2016 ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Immunoglobulin Levels

scholarly journals Occurrence of Serious Infection in Patients with Rheumatoid Arthritis Treated with Biologics and Denosumab Observed in a Clinical Setting

2017 ◽  
Vol 45 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Arthur N. Lau ◽  
Matthew Wong-Pack ◽  
Rod Rodjanapiches ◽  
George Ioannidis ◽  
Sally Wade ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Opportunistic Infection ◽  
Opportunistic Infections ◽  
Biologic Agent ◽  
Risk Of Infection ◽  
Group 4 ◽  
Concurrent Use ◽  
Serious Infection ◽  
Increased Risk ◽  
Group 3

Objective.Previous studies combining biologic disease-modifying antirheumatic drugs (bDMARD) to treat rheumatoid arthritis (RA) have shown an increased risk of infection. However, the risk of infection with concurrent use of denosumab, a biologic agent for the treatment of osteoporosis, and a bDMARD remains unclear. Here, we evaluated the incidence of serious and opportunistic infections in patients treated concurrently with denosumab and a bDMARD and patients treated with a bDMARD alone.Methods.A chart review of patients with RA from 2 Canadian rheumatology practices between July 1, 2010, and July 31, 2014, identified 2 groups of patients: those taking denosumab and a bDMARD concurrently (concurrent group) and those taking only a bDMARD (biologic-alone group). Patients were followed from the time of initiation of denosumab, or a matched index date for the biologic-alone group, to the end of the study or loss to followup. Instances of serious or opportunistic infections were recorded.Results.A total of 308 patients (n = 102 for the concurrent group and n = 206 for the biologic-alone group) were evaluated. Within the concurrent group, 3 serious infection events occurred. Within the biologic-alone group, 4 serious infection events and 1 opportunistic infection event occurred. In both groups, all patients with serious or opportunistic infection recovered, and there were no instances of death during the study period.Conclusion.This study demonstrated a low occurrence of serious and opportunistic infections in patients with RA taking bDMARD, including patients with concurrent denosumab use.

scholarly journals Rate of Infection in Rheumatoid Arthritis Patients

2014 ◽  
Vol 4 (1) ◽  
pp. 15-21
Author(s):  
Aisha A. Al Ghamdi ◽  
Suzan M. Attar
Keyword(s):  
Rheumatoid Arthritis ◽  
University Hospital ◽  
Inflammatory Disorder ◽  
Risk Of Infection ◽  
Kingdom Of Saudi Arabia ◽  
Steroid Use ◽  
Increased Risk ◽  
King Abdulaziz University ◽  
Associated Risk Factors ◽  
Common Infections

Objectives: Rheumatoid arthritis is an autoimmune inflammatory disorder associated with increased risk of infection. The aim of this study was to evaluate infections frequency in rheumatoid arthritis patients and to report the independent associated risk factors. Methods: Rheumatoid arthritis patients (n = 200) were retrospectively reviewed at King Abdulaziz University Hospital Jeddah, Kingdom of Saudi Arabia from January 2008 to December 2010. The rate and predictors of infection were evaluated. Results: The frequency of infection in rheumatoid arthritis patients was (36%). The most common infections were pneumonia, bacteremia and urinary tract infection occurring in 18%, 12%, and 10%, respectively. The strongest and significant predictors for infection were cardiovascular disease (OR = 8.87), renal impairment (OR = 7.12), and steroid use (OR = 1.67). Conclusions: Infection rate in rheumatoid arthritis patients was high but lower than other studies. Comorbid illnesses (renal and cardiovascular diseases) and steroids in rheumatoid arthritis patients predisposed them to develop infections that may necessitate hospitalization. Comorbid illnesses should be managed early and steroids to be used cautiously in order to reduce infection risk among rheumatoid arthritis patients.

scholarly journals Rate of Infection in Rheumatoid Arthritis Patients

2014 ◽  
Vol 4 (1) ◽  
pp. 15-21
Author(s):  
Aisha A. Al Ghamdi ◽  
Suzan M. Attar
Keyword(s):  
Rheumatoid Arthritis ◽  
University Hospital ◽  
Inflammatory Disorder ◽  
Risk Of Infection ◽  
Kingdom Of Saudi Arabia ◽  
Steroid Use ◽  
Increased Risk ◽  
King Abdulaziz University ◽  
Associated Risk Factors ◽  
Common Infections

Objectives: Rheumatoid arthritis is an autoimmune inflammatory disorder associated with increased risk of infection. The aim of this study was to evaluate infections frequency in rheumatoid arthritis patients and to report the independent associated risk factors. Methods: Rheumatoid arthritis patients (n = 200) were retrospectively reviewed at King Abdulaziz University Hospital Jeddah, Kingdom of Saudi Arabia from January 2008 to December 2010. The rate and predictors of infection were evaluated. Results: The frequency of infection in rheumatoid arthritis patients was (36%). The most common infections were pneumonia, bacteremia and urinary tract infection occurring in 18%, 12%, and 10%, respectively. The strongest and significant predictors for infection were cardiovascular disease (OR = 8.87), renal impairment (OR = 7.12), and steroid use (OR = 1.67). Conclusions: Infection rate in rheumatoid arthritis patients was high but lower than other studies. Comorbid illnesses (renal and cardiovascular diseases) and steroids in rheumatoid arthritis patients predisposed them to develop infections that may necessitate hospitalization. Comorbid illnesses should be managed early and steroids to be used cautiously in order to reduce infection risk among rheumatoid arthritis patients.

scholarly journals Toxocara seroprevalence in children from a subtropical city in Argentina

2000 ◽  
Vol 42 (4) ◽  
pp. 235-237 ◽  
Author(s):  
José Mario ALONSO ◽  
María V. I. BOJANICH ◽  
Miryam CHAMORRO ◽  
Jorge O. GORODNER
Keyword(s):  
Environmental Problem ◽  
Hematological Parameters ◽  
Age Groups ◽  
Epidemiological Data ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Elisa Testing ◽  
Significant Difference ◽  
Stool Samples ◽  
Immunoglobulin Levels

Most studies from Argentina have focused on toxocariasis as an environmental problem of big cities, and there are no available data about children infection from small or middle-sized cities. In order to assess the prevalence of anti-Toxocara antibodies in infantile population, 206 children from Resistencia, of both sexes, aged 1-14 years old were studied by Elisa testing with E/S T. canis L2 antigens. Hematological parameters and immunoglobulin levels were determined; five days' stool samples were studied and epidemiological data were obtained by means of a questionnaire to parents. Results showed that 73% of the children had one or more dogs living at home, 57% reported geophagia and 37.9% were positive for Toxocara serology, but there was no significant difference in prevalence neither for boys and girls, nor concerning age. An increased risk of infection was observed in age groups 5-6 and 7-8 for boys, and in age groups 3-4 and 5-6 for girls.

Does Anti-Tumor Necrosis Factor-α Therapy Affect Risk of Serious Infection and Cancer in Patients with Rheumatoid Arthritis?: A Review of Longterm Data

2011 ◽  
Vol 38 (8) ◽  
pp. 1552-1562 ◽  
Author(s):  
EDWARD C. KEYSTONE
Keyword(s):  
Rheumatoid Arthritis ◽  
Tumor Necrosis Factor ◽  
Tumor Necrosis ◽  
Tumor Necrosis Factor Α ◽  
Risk Of Infection ◽  
Serious Infection ◽  
Increased Risk ◽  
Tnf Α ◽  
Factor Α ◽  
Necrosis Factor

Given the important role tumor necrosis factor-α (TNF-α) antagonists play in managing rheumatoid arthritis and the concern for safety during longterm therapy, we reviewed the latest evidence regarding longterm risk of infection and malignancy with TNF-α antagonists. Our objective was to provide clinicians with information that can be used to counsel and monitor patients who may be candidates for biologic therapy for rheumatoid arthritis (RA). Risk is examined in the context of background infection and malignancy rates in RA. Randomized controlled trial (RCT) data and observational studies summarizing the risk of infection and/or malignancy in RA and specific risks associated with the use of anti-TNF-α biologic agents (adalimumab, infliximab, and etanercept) were identified through a PubMed search. Overall, patients with RA appear to have an approximately 2-fold increased risk of serious infection compared to the general population and non-RA controls, irrespective of TNF-α antagonist use. Although data on infection rates with TNF-α antagonist use are contradictory, caution is merited. Recent analyses suggest that the risk of infection is highest within the first year. Regarding malignancy risk, RCT and observational data are also conflicting; how ever, caution is warranted regarding lymphoproliferative cancers in children and adolescents.

High disease activity is associated with an increased risk of infection in patients with rheumatoid arthritis

2011 ◽  
Vol 70 (5) ◽  
pp. 785-791 ◽  
Author(s):  
K. Au ◽  
G. Reed ◽  
J. R. Curtis ◽  
J. M. Kremer ◽  
J. D. Greenberg ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
High Disease Activity ◽  
Risk Of Infection ◽  
Increased Risk

Cardiovascular Risk in Rheumatoid Arthritis and Mechanistic Links: From Pathophysiology to Treatment

2020 ◽  
Vol 18 (5) ◽  
pp. 431-446 ◽  
Author(s):  
George E. Fragoulis ◽  
Ismini Panayotidis ◽  
Elena Nikiphorou
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Current Evidence ◽  
Pharmacological Intervention ◽  
Cvd Risk ◽  
The Past ◽  
Increased Risk ◽  
Cv Disease ◽  
Obesity Hypertension ◽  
Inflammatory Burden

Rheumatoid arthritis (RA) is an autoimmune inflammatory arthritis. Inflammation, however, can spread beyond the joints to involve other organs. During the past few years, it has been well recognized that RA associates with increased risk for cardiovascular (CV) disease (CVD) compared with the general population. This seems to be due not only to the increased occurrence in RA of classical CVD risk factors and comorbidities like smoking, obesity, hypertension, diabetes, metabolic syndrome, and others but also to the inflammatory burden that RA itself carries. This is not unexpected given the strong links between inflammation and atherosclerosis and CVD. It has been shown that inflammatory cytokines which are present in abundance in RA play a significant role in every step of plaque formation and rupture. Most of the therapeutic regimes used in RA treatment seem to offer significant benefits to that end. However, more studies are needed to clarify the effect of these drugs on various parameters, including the lipid profile. Of note, although pharmacological intervention significantly helps reduce the inflammatory burden and therefore the CVD risk, control of the so-called classical risk factors is equally important. Herein, we review the current evidence for the underlying pathogenic mechanisms linking inflammation with CVD in the context of RA and reflect on the possible impact of treatments used in RA.

scholarly journals O06 Baseline predictors of methotrexate-related adverse events in methotrexate-naïve patients with RA

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Ahmad A Sherbini ◽  
James M Gwinnutt ◽  
Kimme L Hyrich ◽  
Suzanne M M Verstappen ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Adverse Events ◽  
Health Assessment ◽  
Prevalence Rates ◽  
Clinical Predictors ◽  
Research Support ◽  
Related Data ◽  
Increased Risk ◽  
One Year

Abstract Background/Aims  Methotrexate (MTX) is the most common treatment for rheumatoid arthritis (RA). The prevalence of adverse events (AEs) associated with MTX treatment for RA have been studied extensively, but there are limited data on the predictors of these AEs. This study aims to summarise the prevalence rates of MTX AEs, including gastrointestinal (GI), neurological, mucocutaneous, and elevated alanine transaminase (ALT) enzyme, and to identify baseline demographic and clinical predictors of these AEs. Methods  The Rheumatoid Arthritis Medication Study (RAMS) is a UK multi-centre prospective cohort study of patients with RA starting MTX for the first time. Relevant demographic, medication, clinical and disease related data were collected at baseline. AEs were reported at six and twelve months follow-ups. The prevalence rates of AEs were calculated based on the proportions of patients who reported having had an AE within one year of follow-up. The associations between candidate baseline predictors and AEs were assessed using multivariable logistic regression. Results  A total of 2,089 patients were included with a mean age of 58.4 (standard deviation: 13.5) years, 1390 (66.5%) were women. 1,814 and 1,579 patients completed the 6 and 12 months follow-up visits, respectively. The prevalence rates of the AEs within one year of follow-up were: GI = 777 (40.6%), mucocutaneous = 441 (23.1%), neurological = 487 (25.5%), elevated ALT (> upper limit of normal [ULN]) = 286 (15.5%). Younger age and being a woman were associated with increased risk of GI AEs, (age: OR 0.97 per year increase in age, 95% CI 0.98, 1.00; male sex: OR 0.58 vs female, 95% CI 0.46, 0.74) (Table 1). Higher baseline Health Assessment Questionnaire (HAQ) score was an independent predictor of GI, mucocutaneous, and neurological AEs. Furthermore, having ALT >1xULN at baseline or history of diabetes was associated with increased risk of subsequent ALT elevation during the study follow-up. Conclusion  In patients with RA starting MTX, GI AEs were the most commonly reported AEs during the first year of follow-up. The identified predictors of AEs may facilitate discussions between clinicians and patients prior to commencing MTX, and may lead to increased adherence and consequently improved effectiveness. Disclosure  A.A. Sherbini: None. J.M. Gwinnutt: Grants/research support; BMS. K.L. Hyrich: Member of speakers’ bureau; Abbvie. Grants/research support; Pfizer, UCB, BMS. S.M.M. Verstappen: Consultancies; Celltrion. Member of speakers’ bureau; Pfizer. Grants/research support; BMS.

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