J Korean Rheum Assoc.  2010 Sep;17(3):246-253.

The Incidence of Serious Infection among Rheumatoid Arthritis Patients Exposed to Tumor Necrosis Factor Antagonists

• Kim HO
• Kang KY
• Ju JH
• Kim HY
• Park SH

Abstract

OBJECTIVE
We wanted to investigate the incidence of serious infections among the rheumatoid arthritis (RA) patients who were treated with tumor necrosis factor alpha (TNF-alpha) antagonists.
METHODS
We enrolled the 175 RA patients who were treated with TNF-alpha antagonists for at least 3 months during February 2003 to July 2008, and these patients were in the SMART-b cohort of Kangnam St. Mary's hospital. Patients were prescribed infliximab, etanercept or adalimumab. The data was retrospectively collected.
RESULTS
The incidence of serious infections among the RA patients treated with TNF-alpha was significantly increased according to the survival analysis, as compared with that of those patient treated with conventional DMARDs (p<0.01). The most common serious infection was pneumonia. There was no significant difference in the incidence of serious infections among the three TNF-alpha antagonists used in this study (p=0.96). But the serious infections occurred more often in the patients who received more than 10 mg methotrexate (MTX) per week (p=0.02).
CONCLUSION
RA patients treated with TNF-alpha antagonists had a higher incidence of serious infection. Therefore, close monitoring for serious infection is needed for RA patients who are receiving TNF-alpha antagonists.

Keyword

Rheumatoid arthritis; Serious infection; TNF-alpha antagonists

MeSH Terms

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antirheumatic Agents
Arthritis, Rheumatoid
Cohort Studies
Humans
Immunoglobulin G
Incidence
Methotrexate
Pneumonia
Receptors, Tumor Necrosis Factor
Retrospective Studies
Tumor Necrosis Factor-alpha
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antirheumatic Agents
Immunoglobulin G
Methotrexate
Receptors, Tumor Necrosis Factor
Tumor Necrosis Factor-alpha

Figure

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  Fig. 1. Incidence of serious infection in rheumatoid arthritis patients according to TNF- antagonists exposure (p.01). ∗TNF- antagonists group, conventional DMARDs group.

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  Fig. 2. Incidence of serious infection among TNF- antagonists (p=0.96). ∗Inflixim ab, Etanercept, Adalimumab

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