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for physicians or Medical Students
Clinical Context
Although biologic agents have greatly improved outcomes for patients with autoimmune diseases, substantial concern remains about risk for serious infections associated with these drugs. A previous study by Grijalva and colleagues (JAMA. 2011;306:2331-2339) examined 1172 cases of serious infection among patients with rheumatoid arthritis (RA), psoriasis, and inflammatory bowel disease. Pneumonia and skin or soft tissue infection accounted for most cases of infection. Compared with nonbiologic treatment regimens, anti–tumor necrosis factor (TNF) drugs were not associated with a significant increase in the risk for infection in any disease state studied.
Nonetheless, the rate of serious infection among patients with RA treated with biologic agents is estimated to be 3 to 7 infections per 100 person-years. The current study by Curtis and colleagues examined factors that might predict a higher rate of serious infection associated with the use of anti-TNF drugs for RA.
