How to reduce morbidity and mortality from chest infections in rheumatoid arthritis

Abstract

-Morbidity and mortality from pneumonia is increased in patients with rheumatoid arthritis. Factors contributing to this have been recently identified and a number of recommendations have been implemented in an attempt to reverse this trend. The present paper shows that these measures have combined to produce a fourfold reduction in both admissions and case fatality rates. In the study population, immunisation rates against influenza and pneumococcus have improved to 86% and 65%, oral steroid consumption has halved and disease modifying drugs were usually appropriately suspended during acute infection. These measures may now merit more widespread adoption.

Komorbiditeti kod oboljelih od reumatoidnog artritisa

“…Ovi nalazi su bili nezavisni od starosti, pola i statusa pušenja. Potrošnja oralnih kortikosteroida se smanjila za 50%, dok je stopa imunizacije oboljelih od RA protiv gripa poboljšana za 86%, a protiv pneumokoka do 65% [24][25][26][27][28][29][30].…”

“…Bolesnici sa RA imaju povećan rizik od infekcija, prije svega respiratornog i urinarnog sistema [30]. Ovaj povećan rizik korelira s aktivnošću i težinom bolesti.…”

“…Ovaj povećan rizik korelira s aktivnošću i težinom bolesti. Dodatni faktori rizika su dob, aktivnost bolesti, te plućni i kardiovaskularni komorbiditet [30]. Primjena lijekova može dodatno povisiti taj rizik.…”

Infecciones en pacientes reumatológicos asociadas a corticosteroides y antagonistas del factor de necrosis tumoral α

“…En una cohorte de pacientes con AR en Australia, se pudo observar que la incorporación sistemática de la vacuna contra influenza y S. pneumoniae polisacárida 23 valente, junto a medidas tales como la minimización de corticoterapia a largo plazo, la suspensión de medicamentos modificantes de la enfermedad en caso de ingreso por neumonía, el uso de ácido folínico ante leucopenia < 5.000/mm 3 (en usuarios de metotrexato) y de estimuladores de colonias ante neutropenias < 500/ mm 3 , permitieron reducir el número de ingresos por este problema y la mortalidad en los ingresos 88 .…”

Vaccination in rheumatology: the present and prospects

“…При СКВ частота пневмонии колеблется от 6 до 28% [4,26,29]. Смертность от пневмонии при РА составляет 8-22% [2,27,28], при СКВ -от 23 до 27% [11,[29][30][31], при РЗ в целом -от 11 до 22% [16,18].…”