Infections in patients with rheumatoid arthritis treated with biologic agents

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Infections in patients with rheumatoid arthritis treated with biologic

agents.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & dopt=Abstra\

ct & list_uids=16255017

Listing J, Strangfeld A, Kary S, Rau R, von Hinueber U, Stoyanova-Scholz M,

Gromnica-Ihle E, Antoni C, Herzer P, Kekow J, Schneider M, Zink A.

German Rheumatism Research Centre, Schumannstrasse 21/22, D-10117 Berlin,

Germany. Listing@...

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 22.6 among patients

receiving etanercept, 28.3 among patients receiving infliximab, and 6.8

among controls.

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 6.4, 6.2, and 2.3, respectively. After adjusting for differences in the

case patient mix, the relative risks of serious adverse events were 2.2 for

patients receiving etanercept and 2.1 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 inhibitors.

PMID: 16255017 [PubMed - indexed for MEDLINE]