High disease activity is associated with an increased risk of infection in patients with rheumatoid arthritis

Au, Karen; Reed, George W.; Curtis, Jeffrey R.; Kremer, Joel M.; Greenberg, Jeffrey D.; Strand, Vibeke; Fürst, Daniel E.; Investigators, Corrona

doi:10.1136/ard.2010.128637

Cited by 292 publications

(229 citation statements)

References 25 publications

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“…We have two explanations for this discrepancy. First, in both arms of the Utrecht Study disease control was not tight, in contrast to in CAMERA-II; inflammatory disease has negative effects on bone, and also on lipids, endothelium, glucose metabolism and infection risk [17,18,19,20]. In this way, negative effects of the inflammatory disease are entangled with adverse effects of the GC therapy given for the inflammatory disease.…”

Section: Discussionmentioning

confidence: 99%

Glucocorticoids in Early Rheumatoid Arthritis: Are the Benefits of Joint-Sparing Effects Offset by the Adverse Effect of Osteoporosis? The Effects on Bone in the Utrecht Study and the CAMERA-II Study

Jw²,

Jm³

2014

Neuroimmunomodulation

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This paper reviews the clinical effects on bone of 10 mg of prednisone daily in early rheumatoid arthritis, given for 2 years in the Utrecht Study and in the second CAMERA (Computer- Assisted Management in Early Rheumatoid Arthritis) Study, and addresses the question whether there were joint-sparing effects and whether these were offset by adverse effects, especially osteoporosis. We conclude that a 2-year adjunct treatment with 10 mg of prednisone daily increases the benefits of disease-modifying antirheumatic drug therapy and has joint-sparing properties, even if added to the tight control methotrexate-based strategy aiming for remission. Importantly, with good control of inflammation and adequate use of calcium, vitamin D and bisphosphonates - according to national or international guidelines - steroid-induced osteoporosis is rare over 2 years.

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Section: Discussionmentioning

confidence: 99%

Glucocorticoids in Early Rheumatoid Arthritis: Are the Benefits of Joint-Sparing Effects Offset by the Adverse Effect of Osteoporosis? The Effects on Bone in the Utrecht Study and the CAMERA-II Study

Jw²,

Jm³

2014

Neuroimmunomodulation

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“…10 Au et al reported that increased risk of infections is related to RA disease activity, independent of treatment with DMARDs, with more active disease associated with higher rate of all types of infections. 29 Also, the presence of airways colonization in patients with RA-BR was reported to be associated with increased risk of infections (2.5 Ϯ 1.7 infections per patient-year). 30 However, in the same study, the use of DMARDs was a more powerful predictor of lowerrespiratory-tract infection than airway colonization, consistent with other reports.…”

Section: Infectionsmentioning

confidence: 99%

Coexistence of Bronchiectasis and Rheumatoid Arthritis: Revisited

2013

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The presence of bronchiectasis (BR) in patients with rheumatoid arthritis (RA) has been recognized for many decades; nevertheless, little research has been undertaken in this area. It is important to recognize that BR coexistent with RA differs from the other types of BR. The purpose of this descriptive review was to delineate the epidemiology, etiology, risk factors, pulmonary function testing, imaging, prognosis and management of concomitant BR and RA. To inform our study we searched the PubMed, EMBASE, CINAHL, and MEDLINE databases, using combinations of the following key words: computed tomography, lung function tests, rheumatoid arthritis, bronchiectasis, biological agents, and interstitial lung disease. The number of published papers covering this topic is limited, but several relevant conclusions can be drawn. Patients with concomitant RA and BR have worse obstructive airways disease, increased susceptibility to recurrent pulmonary infections, faster lung function decline, and higher mortality, compared with subjects with either RA or BR alone. The use of disease-modifying anti-rheumatic drugs (both biological and non-biological) for RA in RA-BR patients imparts a further challenge in managing these patients. Although there are not any published guidelines on the management of coexisting RA-BR, we have attempted to provide such recommendations, based on the literature review and our experience.

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“…In this RA population, risk of PJI was only 3.5% if revision arthroplasty surgery was performed in a joint with no prior PJI [5]. Active RA is also a risk factor for infection, and patents with more swollen and tender joints are at higher risk for infection, adding to the conflict between holding and continuing disease-modifying anti-rheumatoid drugs (DMARDs) perioperatively [1].…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic Joint Infection in Patients with Inflammatory Joint Disease: a Review of Risk Factors and Current Approaches to Diagnosis and Management

et al. 2013

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High disease activity is associated with an increased risk of infection in patients with rheumatoid arthritis

Abstract: In this large cohort of RA patients, higher disease activity was associated with a higher probability of developing infections.

Cited by 292 publications

References 25 publications

Glucocorticoids in Early Rheumatoid Arthritis: Are the Benefits of Joint-Sparing Effects Offset by the Adverse Effect of Osteoporosis? The Effects on Bone in the Utrecht Study and the CAMERA-II Study

Glucocorticoids in Early Rheumatoid Arthritis: Are the Benefits of Joint-Sparing Effects Offset by the Adverse Effect of Osteoporosis? The Effects on Bone in the Utrecht Study and the CAMERA-II Study

Coexistence of Bronchiectasis and Rheumatoid Arthritis: Revisited

Periprosthetic Joint Infection in Patients with Inflammatory Joint Disease: a Review of Risk Factors and Current Approaches to Diagnosis and Management

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