EDITORIAL - Infections, drugs, and RA: what have we learned?

[Guest guest]

Journal of Rheumatology

March 2008

Editorial

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Infections, Drugs, and Rheumatoid Arthritis. What Have We Learned?

JONATHAN S. COBLYN, MD,

Division of Rheumatology, Immunology and Allergy,

Department of Internal Medicine,

Brigham and Women's Hospital,

Harvard Medical School,

Boston, Massachusetts, USA

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According to French writer Sebastian-Roch Nicolas de Chamfort, in his

Maximes et Pensées, " Philosophy, like medicine, has plenty of drugs,

few good remedies, and hardly any specific cures. " One can easily

substitute rheumatoid arthritis (RA) for philosophy and occasionally

question whether our drugs used for RA are " good remedies. "

It is and has been well known that the longterm morbidity and

mortality are higher in RA versus the general population. Reasons for

increased morbidity and mortality include, among others, increased

risk of infections, cardiovascular diseases, pulmonary complications,

and neoplasms including non-Hodgkin's lymphoma. However, there is

still no clear indication why this is so, or what component of this

increased risk is due to the disease itself, to comorbid factors

associated with ill health in general (diabetes, cancer, heart and

renal disease), or even to the drugs we use to treat the disease.

While we assume our new therapies have decreased morbidity and

mortality, there are studies that show this may not be true1.

Recently, , et al reported that mortality in patients with RA

was similar across 2 different treatment eras, the latter being the

period encompassing use of biologic therapies (albeit perhaps without

a long enough longitudinal sample2).

***********************************************************

Read the entire editorial here:

http://www.jrheum.com/subscribers/08/03/375.html

--

Not an MD

[Guest guest]

If you are taking steriods or have ever taken them or plan to take

them, I recommend reading the entire article.

Three weeks ago, I decided to take predisone for the following week I

had to go to a conference in San Francisco. At the conference, I was

around several people who had some sort of virus thing. Well, of

course, I caught it and have been sick ever since. I wish I had know

the connection between infection and predisone before. I would have

stopped the predisone as soon as I got sick!

Thanks again, , for finding all this good info for us!!!!!!

>

> Journal of Rheumatology

> March 2008

> Editorial

>

> --------------------------------------------------------------------

------------

>

> Infections, Drugs, and Rheumatoid Arthritis. What Have We Learned?

> JONATHAN S. COBLYN, MD,

> Division of Rheumatology, Immunology and Allergy,

> Department of Internal Medicine,

> Brigham and Women's Hospital,

> Harvard Medical School,

> Boston, Massachusetts, USA

>

>

> --------------------------------------------------------------------

------------

>

> According to French writer Sebastian-Roch Nicolas de Chamfort, in

his

> Maximes et Pensées, " Philosophy, like medicine, has plenty of drugs,

> few good remedies, and hardly any specific cures. " One can easily

> substitute rheumatoid arthritis (RA) for philosophy and occasionally

> question whether our drugs used for RA are " good remedies. "

>

> It is and has been well known that the longterm morbidity and

> mortality are higher in RA versus the general population. Reasons

for

> increased morbidity and mortality include, among others, increased

> risk of infections, cardiovascular diseases, pulmonary

complications,

> and neoplasms including non-Hodgkin's lymphoma. However, there is

> still no clear indication why this is so, or what component of this

> increased risk is due to the disease itself, to comorbid factors

> associated with ill health in general (diabetes, cancer, heart and

> renal disease), or even to the drugs we use to treat the disease.

> While we assume our new therapies have decreased morbidity and

> mortality, there are studies that show this may not be true1.

>

> Recently, , et al reported that mortality in patients with

RA

> was similar across 2 different treatment eras, the latter being the

> period encompassing use of biologic therapies (albeit perhaps

without

> a long enough longitudinal sample2).

>

>

> ***********************************************************

> Read the entire editorial here:

>

> http://www.jrheum.com/subscribers/08/03/375.html

>

>

> --

>

> Not an MD

>