Infections More Common with Rheumatoid Arthritis

October 21, 2002

NEW YORK (Reuters Health) - People with rheumatoid arthritis (RA) have a

higher-than-average rate of a wide variety of infections, particularly those

affecting the joints, bones and skin, according to new study findings.

Frequent infections associated with RA have been reported for years, with

patients showing a particular vulnerability to lung infections and septic

arthritis--joint inflammation caused by invading bacteria. But because these

reports have been based on hospitalized patients, the overall infection risk

among people with RA has been unclear, the study authors point out.

In their look at people with and without RA living in Rochester, Minnesota,

the researchers found that those with the disease were 70% more likely to

acquire any infection over the study period.

The most frequent infections were septic arthritis, a bone infection called

osteomyelitis and infections of the skin and soft tissue, such as wound

infections and shingles.

Dr. Sherine E. and colleagues at the Mayo Clinic in Rochester

reported the findings in a recent issue of the journal Arthritis &

Rheumatism.

Rheumatoid arthritis occurs when the immune system, for unknown reasons,

mistakenly attacks the joints, leading to inflammation, swelling and pain.

Over time, this process erodes the bone and soft tissue within the joints.

Because of the abnormal immune assault, drugs that suppress components of

the immune system are central in RA treatment.

According to 's team, these drugs, the disease itself, or RA-related

factors such as the need for joint surgery could be responsible for the

heightened infection rate.

" These results, " the study authors write, " underscore the need for

additional research to discover the determinants of this increased infection

risk in RA. "

For the study, the researchers reviewed the medical records of 609 adults

with RA diagnosed between 1955 and 1994, and compared each patient with an

adult the same age and sex without RA. Participants, more than 73% of whom

were women, were followed for 13 to 15 years, on average.

The researchers found that septic arthritis was 15 times more common among

RA patients. Osteomyelitis was nearly 11 times more common, and skin and

soft-tissue infections more than three times as common. Increased risks were

also found for infections of the lungs and abdominal organs, among others.

SOURCE: Arthritis & Rheumatism 2002;46:2287-2293.

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