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ANTI-TNF THERAPY AND THE RISK OF MALIGNANCIES AND INFECTIONS IN INFLAMMATORY RHEUMATIC DISEASES - OUR EXPERIENCE

Mislav Pap orcid.org/0000-0003-2599-3195 ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia
Ivana Sapina ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia
Nadica Laktašić Žerjavić ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Iva Žagar ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Kristina Kovač Durmiš ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Nataša Kalebota ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia
Petra Kovačević ; School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
Ivan Ljudevit Caktaš ; Lječilište Topusko, Department of Physical Medicine and Rehabilitation, Topusko, Croatia
Vanja Dekleva ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia
Duje Birkić ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia
Helena Kolar Mitrović ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia
Porin Perić ; University Hospital Centre Zagreb, Department of Rheumatology and Rehabilitation, Zagreb, Croatia ; School of Medicine, University of Zagreb, Zagreb, Croatia

Sažetak

Background: Early diagnosis is the key to successful treatment of inflammatory rheumatic diseases and the use of conventional
disease-modifying antirheumatic drugs (csDMARD) and biologic disease-modifying antirheumatic drugs (bDMARD) or biologics
have substantially contributed to better disease control. Biological drugs have been approved for the treatment of rheumatoid
arthritis (RA), juvenile arthritis (JIA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA).
Subjects and methods: The study involved 79 adult patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS),
psoriatic arthritis (PsA) or undifferentiated spondyloarthropathy (USpA) - the last three clinical entities belong to a common group
called spondyloarthropathies (SpA); receiving anti-TNF therapy at the department of Rheumatology and Rehabilitation, Clinical
Hospital Center Zagreb. The duration of therapy was a minimum of 1 month, with the mean duration of 32.0􀁲24.0 months. The
infections recorded were infections that appeared during treatment or soon after the treatment was stopped.
Results: During the course of therapy 17 patients (21.5%) experienced an infection, with the total number of 21 infections. This
resulted in an overall incidence rate (IR) of 9.9/100 patient-years. Of the patients with RA 76.5% developed an infection, which was
significantly higher than for patients with SpA (p<0.001). The IR/100 patient-years for all infections in RA patients was 23.7 compared
to 2.8 in patients with SpA. Female gender was associated with a significantly higher infection rate (70.6%, p=0.005). There were 8
infections that were considered serious, yielding an IR of 3.8/100 patient-years. There was only one malignancy case in our study.
Conclusion: Every fifth patient developed an infection during the course of anti-TNF therapy, and more than one third of all
infections were serious. RA and female gender was associated with a significantly increased number of infections.

Ključne riječi

anti-tnf therapy; inflammatory rheumatic diseases; infections; malignancies

Hrčak ID:

271844

URI

https://hrcak.srce.hr/271844

Datum izdavanja:

19.10.2021.

Posjeta: 368 *