Serious infections with antirheumatic therapy: are biologicals worse?
This paper reviews the current evidence for the role of antirheumatic therapy in the development of serious infections in patients with rheumatoid arthritis (RA). Prednisone is clearly associated with increased infectious risk, but no definitive data link methotrexate to infection. Emerging data suggest that biological agents also pose increase infectious risk, particularly when used in combination with corticosteroids or methotrexate. Further research is needed in this important aspect of RA treatment. In the meantime, the author recommends that physicians should remain vigilant for serious infections in their patients with RA and use appropriate vaccines and screening procedures to mitigate their risk.
Winthrop
K L
KL
Division of Infectious Diseases, School of Medicine, Oregon Health Sciences University, 3375 SW Terwilliger Boulevard, Portland, OR 97239-4197, USA. winthrop@ohsu.edu.
D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D053590:Interleukin 1 Receptor Antagonist Protein / Q000009:adverse effects; D009894:Opportunistic Infections / Q000139:chemically induced*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D018501:Antirheumatic Agents; D005938:Glucocorticoids; D007155:Immunologic Factors; D053590:Interleukin 1 Receptor Antagonist Protein; D014409:Tumor Necrosis Factor-alpha