Frequency of infection among patients with rheumatoid arthritis versus patients with osteoarthritis or soft tissue rheumatism.
ABSTRACT We compared the frequencies and types of infections that occurred in 448 patients with rheumatoid arthritis (RA) versus those occurring in 185 control patients who had osteoarthritis or soft tissue rheumatism. At least 1 infection developed in 23% of the RA patients and in 27% of the control patients. Using a series of risk factors, we found no substantial difference in the risk of infection in RA patients compared with that in control patients. Some of these factors, such as being female, having poor functional capacity, and receiving glucocorticoid treatment, were associated with different levels of risk for infection, but the levels were similar in RA patients and control patients.
[show abstract] [hide abstract]
ABSTRACT: There is an increasing number of rheumatoid patients who get septic arthritis. Chronic use of steroids is one of the important predisposing factors. The clinical picture of septic arthritis is different in immunocompromised patients like patients with rheumatoid arthritis. The diagnosis and management are discussed in this review article.Journal of Orthopaedic Surgery and Research 02/2008; 3:33.
Article: [Infections in patients with rheumatoid arthritis receiving anti-cytokine therapy: biological mechanisms and clinical aspects].[show abstract] [hide abstract]
ABSTRACT: Different animal studies show that several proinflammatory cytokines are essential for natural resistance to specific infections, particularly versus intracellular organisms. However, uncontrolled overproduction of some proinflammatory cytokines, in diseases such as rheumatoid arthritis, can be just as dangerous to the host as the absence of the same cytokines. Reduction in the production and/or activities of proinflammatory cytokines in rheumatoid arthritis remains a therapeutic objective for many patients. The tumour necrosis factor-alpha (TNF-alpha) blockers infliximab, etanercept and adalimumab and the recombinant interleukin 1 (IL-1) receptor antagonist anakinra are effective in patients with active rheumatoid arthritis. However, there is a growing body of clinical evidence that neutralization of TNF-alpha is associated with an increased risk of opportunistic infections, including mycobacterial diseases. Blockade of IL-1 activity with the IL-1 receptor antagonist (IL-1Ra) appears, at present, to be relatively safe. Postmarketing experience and pharmacovigilance programs are necessary to determine the overall safety profile of the new agents. At this time, treating physicians must weigh carefully the benefits of biologics against their safety, particularly in patients at risk of infection.Reumatismo 55(4):224-35.
[show abstract] [hide abstract]
ABSTRACT: The development of rheumatic diseases after immunization has been reported in the medical literature but a causal relationship has not been established. Infections remain an important cause of morbidity and mortality in patients with rheumatic diseases who may be immunodepressed for immunological dysfunctions or immunosuppressed due to the pharmacologic therapy. Although vaccines against infectious diseases are considered the standard way in preventive medicine, it is still a controversial issue among rheumatologists whether or not patients with rheumatic disorders should undergo vaccination. In recent decades increased numbers of studies on influenza and pneumococcal vaccines administered to patients with systemic lupus erythematosus have proven their safety. These vaccinations, generally immunogenic (i.e. able to induce a protective level of specific antibodies), may not induce an adequate response in patients receiving immunosuppressive therapy. The safety and the immunogenity of Tetanus toxoid, and HBV vaccinations in SLE patients are not completely defined so far. Considering the few available studies, influenza, pneumococcal, and HBV vaccines seem to be safe and immunogenic in patients with rheumatoid arthritis. The effect of TNF blocking therapies on human immune responses to vaccination is discussed. We also review existing knowledge on vaccination in patients with Sjogren's syndrome and in children with rheumatic disorders, discussing risks and benefits.Current Rheumatology Reviews 01/2007; 300.