title: Anti-TNF-α and risk of infections: the experience in one center.
abstract: OBJECTIVE
  In the last years there is an increasing interest for the question of whether patients treated with antitumour necrosis factor-α (TNF-α) agents are at increased risk of infections. We aim to assess the possible role of anti-TNF-α treatment in the increase of the risk of infections in a population of patients affected by rheumatoid arthritis or psoriatic arthritis.
  
  
  METHODS
  We analyzed data of patients affected by chronic arthritis treated with anti-TNF-α to investigate the risk of infections. Statistical analysis was done using STATA software.
  
  
  RESULTS
  The odds ratio for patients treated with anti-TNF-α who developed infections was 1.61 (CI: 0.88, 2.92, P<0.11). We found an odds ratio of 1.41 (CI: 0.74, 2.68, P<0.29) in patients treated with anti-TNF-α who developed urinary tract infection, and an odds ratio of 2.63 (CI: 0.31, 22.19, P<0.37) in patients treated with anti-TNF-α who developed herpes zoster.
  
  
  CONCLUSIONS
  These results seems to indicate a role of anti-TNF-α treatment in the risk of infection. Nevertheless, our results are not statistically significant probably because the sample sizes are too small and the time of observation among patients is variable. Moreover, other confounding factors may be gender, age and the different degrees of disease activity and comorbidity. In conclusion, limitations in the study size and design preclude definitive conclusions about the question of whether patients treated with anti-TNF-α agents are at increased risk of infections. The performance of additional research are needed to answer this question.
authors.affiliation: Department of Rheumatology University of Foggia Medical School, Foggia, Italy - fp.cantatore@unifg.it.
authors.forename: N
authors.initials: N
authors.lastname: Maruotti
authors.forename: F
authors.initials: F
authors.lastname: D'Onofrio
authors.forename: A
authors.initials: A
authors.lastname: Neve
authors.forename: N
authors.initials: N
authors.lastname: Santoro
authors.forename: A
authors.initials: A
authors.lastname: Corrado
authors.forename: F P
authors.initials: FP
authors.lastname: Cantatore
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D000068582:Certolizumab Pegol; D002908:Chronic Disease; D015897:Comorbidity; D000068800:Etanercept; D005260:Female; D006562:Herpes Zoster / Q000150:complications; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage; D007074:Immunoglobulin G / Q000009:adverse effects; D007239:Infections / Q000150:complications / Q000209:etiology*; D000069285:Infliximab; D008297:Male; D008499:Medical Records; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D016017:Odds Ratio; D011092:Polyethylene Glycols / Q000008:administration & dosage; D018124:Receptors, Tumor Necrosis Factor; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014552:Urinary Tract Infections / Q000150:complications
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D007140:Immunoglobulin Fab Fragments; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D011092:Polyethylene Glycols; C529000:golimumab; D000069285:Infliximab; D000068879:Adalimumab; D000068800:Etanercept; D000068582:Certolizumab Pegol; D008727:Methotrexate