Steroid treatment for arthritis ups pneumonia risk

March 16, 2006

Thu Mar 16, 2006 6:21 PM GMT

NEW YORK (Reuters Health) - Patients with rheumatoid arthritis who

are treated with low-dose prednisone have an increased risk of coming

down with pneumonia, a new study indicates.

However, the findings also show that most other drugs used to treat

arthritis don't have this drawback.

Prednisone, a steroid, tends suppresses the immune system and at high

enough doses this could increase the chances of infection. " If the

results of this study are correct, they may undermine the current

belief that low-dose prednisone is safe, " Dr. Frederick Wolfe, with

the Arthritis Research Center Foundation in Wichita, Kansas, and his

colleagues suggest.

Even though prednisone is commonly used to treat arthritis patients,

there have been no studies looking at it's effect on the risk of

pneumonia -- which is one of the major causes of death in patients

with rheumatoid arthritis, the authors point out.

Wolfe's team followed 16,788 arthritis patients, average age 62

years, participating in the National Data Bank for Rheumatic Diseases

study. The subjects completed questionnaires early in 2001 and every

6 months for up to 3.5 years.

The investigators report in the medical journal Arthritis &

Rheumatism that the most common treatments were methotrexate,

prednisone, Remicade, hydroxychloroquine and Enbrel.

During follow-up, there were 749 hospitalizations for pneumonia.

After adjusting for factors such as smoking, age and arthritis

severity, the researcher found that prednisone was associated with a

70 percent increased risk of pneumonia.

There was no significantly increased risk associated with so-called

TNF-blockers -- Remicade, Enbrel or Humira -- or with methotrexate,

hydroxychloroquine or sulfasalazine.

" Prednisone use is common in rheumatoid arthritis and is therefore a

potentially important health risk, " Wolfe's team concludes. They

point out, however, that their data " do not address the issue of net

benefit, " so discontinuing prednisone " might provoke equally

undesirable adverse effects. "

SOURCE: Arthritis & Rheumatism, February 2006.

type=healthNews & storyID=2006-03-16T182141Z_01_COL666041_RTRIDST_0_HEALTH

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