4.4 Review

Infections in rheumatoid arthritis

Journal

CURRENT OPINION IN RHEUMATOLOGY
Volume 29, Issue 4, Pages 323-330

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOR.0000000000000389

Keywords

anti-tumour necrosis factor drugs; fungal and viral infections; infections; newer biological drugs; orthopaedic surgery; perioperative infections

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Purpose of review The purpose of this review is to provide an update concerning recent advances in the evidence-based study of serious infections in patients with rheumatoid arthritis (RA) treated with biological drugs or conventional disease-modifying antirheumatic drugs (DMARDs), concentrating on studies published in the last 18 months. Recent findings New studies have further strengthened existing evidence relating the use of biological drugs to serious infections. The risk does not seem to be any different with short-term or long-term use. There is still a lack of conclusive studies identifying biomarkers, but it is plausible that the drugs have direct effects on cytokines and cell activity and then serious infections. Summary The frequent infections of patients with RA may be due to the disease itself (altered immunological function, disability, immobility, joint surgery), extra-articular manifestations or DMARDs, immunosuppressants and steroids. The use of biological drugs lead to the development of serious infections including tuberculosis. Patients should be informed of their increased risk, and physicians need to be aware of these complications and how to treat them.

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