Rheumatoid Arthritis Disease Activity and Disability Affect the Risk of Serious Infection Events in RADIUS 1

Abstract

Increased RA disease activity and disability were each associated with a significantly increased SIE risk in the RADIUS 1 cohort, which could not be completely accounted for by disability.

Crohn’s Disease Activity and Concomitant Immunosuppressants Affect the Risk of Serious and Opportunistic Infections in Patients Treated With Adalimumab

“…Our analysis confi rmed this hypothesis using a rigorous quantitative measurement of disease activity, which was assessed frequently in the pooled studies. In rheumatoid arthritis, higher disease activity has also been shown to be an independent risk factor for serious infection in several studies, with a 27-42% increase in risk for every unit increase in the Disease Activity Score in 28 joints ( 27,28 ) and a 7.7% increase in risk for every fi ve-unit increase in the Clinical Disease Activity Index ( 29 ).…”

Perioperative medical management for patients with RA, SPA, and SLE undergoing total hip and total knee replacement: a narrative review

“…However, a recent study that used billing data to specify the timing of infliximab infusions in relation to surgery found no clear increase in risk of infection when infliximab was infused within 4 weeks of surgery compared to longer periods of drug withholding [34]. Disease activity and severity may contribute to the risk of peri-operative infection for RA, SPA, and SLE, and might confound the reported association with medication use [14,37]. Use of glucocorticoids, however, has been consistently associated with an increased risk of infection in multiple settings-including surgery -at dosages above 15 mg./day, yet supraphysiologic doses of glucocorticoids ("stress dose steroids") are routinely administered on the day of surgery out of concern for hemodynamic instability [38,39].…”

Further Evidence for Influenza and Pneumococcal Vaccination in Patients Treated with Disease Modifying Antirheumatic Drugs and Anti-Tumor Necrosis Factor Agents

“…Antirheumatic treatment, in particular longterm use of glucocorticoids, but also traditional disease modifying antirheumatic drugs (DMARD) and biological remedies have all been shown to increase risk of infections 4,5,6 . In addition, higher age, concomitant smoking, common comorbidities such as chronic obstructive pulmonary disease, diabetes mellitus, kidney disease, or malignancies contribute to increased infection risk 2,3,5 .…”

“…Patients with rheumatoid arthritis (RA) have increased risk of infections including possible vaccine-preventable ones 1,2,3,4,5,6,7 . Susceptibility to infections is considered to be partly associated with RA itself, i.e., immunological alterations as a part of the disease, disease activity, and disability 2,3 .…”

“…Susceptibility to infections is considered to be partly associated with RA itself, i.e., immunological alterations as a part of the disease, disease activity, and disability 2,3 . Antirheumatic treatment, in particular longterm use of glucocorticoids, but also traditional disease modifying antirheumatic drugs (DMARD) and biological remedies have all been shown to increase risk of infections 4,5,6 .…”