scholarly journals Risk Factors for Targeted Fungal and Mycobacterial Infections in Patients Taking Tumor Necrosis Factor Inhibitors

2016 ◽  
Vol 68 (3) ◽  
pp. 597-603 ◽  
Author(s):  
Elizabeth Salt ◽  
Amanda T. Wiggins ◽  
Mary Kay Rayens ◽  
Moises A. Huaman ◽  
David Mannino ◽  
...  
2012 ◽  
Vol 18 (11) ◽  
pp. 1502-1511 ◽  
Author(s):  
Mike J.L. Peters ◽  
Alper M. van Sijl ◽  
Alexandre E. Voskuyl ◽  
Naveed Sattar ◽  
Yvo M. Smulders ◽  
...  

2021 ◽  
Vol 14 ◽  
pp. 175628482199779
Author(s):  
Su Jin Choi ◽  
Soo Min Ahn ◽  
Ji Seon Oh ◽  
Seokchan Hong ◽  
Chang-Keun Lee ◽  
...  

Background: Anti-tumor necrosis factor (TNF) agents are increasingly used for rheumatic diseases and inflammatory bowel disease (IBD), but are associated with the development of anti-TNF-induced lupus (ATIL). Nonetheless, few ATIL studies on non-Caucasian IBD patients exist. Here, we investigated the incidence, clinical features, and risk factors of ATIL in Korea. Methods: We retrospectively reviewed the medical records of IBD patients undergoing anti-TNF therapy at our tertiary IBD center between 2008 and 2020. ATIL was diagnosed as a temporal association between symptoms and anti-TNF agents, and the presence of at least one serologic and non-serologic American College of Rheumatology criterion. The risk factors for ATIL occurrence were assessed using multivariate Cox regression analysis. Results: Of 1362 IBD patients treated with anti-TNF agents, 50 (3.7%) ATIL cases were suspected, of which 14 (1.0%) received a definitive diagnosis. Arthritis and mucocutaneous symptoms were observed in 13 and 4 patients, respectively. All ATIL cases were positive for anti-nuclear and anti-dsDNA antibodies. Four patients (30.8%) improved while continuing anti-TNF therapy. At the final follow up, the ATIL group ( n = 14) had a lower IBD remission rate (30.8% versus 68.8%, p = 0.019) than the non-ATIL group ( n = 36). Ulcerative colitis and longer disease duration were associated with ATIL occurrence, with hazard ratios of 7.017 ( p = 0.005) and 1.118 ( p = 0.002), respectively. Conclusion: Although rare, ATIL is associated with poor treatment response to IBD in Korean patients. ATIL should be considered if arthritis and mucocutaneous symptoms develop during anti-TNF therapy for IBD.


2014 ◽  
Vol 41 (10) ◽  
pp. 2078-2084 ◽  
Author(s):  
Melissa L. Mannion ◽  
Fenglong Xie ◽  
Jeffrey R. Curtis ◽  
Timothy Beukelman

Objective.Using administrative data from a large commercial US health insurer, we investigated temporal trends in medication use among children diagnosed with juvenile idiopathic arthritis (JIA).Methods.Children with ≥ 1 physician diagnosis code for JIA in the calendar years 2005 through 2012 were included. Use of tumor necrosis factor inhibitors (TNFi), methotrexate (MTX), nonsteroidal antiinflammatory drugs (NSAID), and oral glucocorticoids (GC) was determined. Temporal changes in medication usage were evaluated with the Cochran-Armitage test for trend. We used paired t-tests to evaluate the use of NSAID and GC in the 6 months before and after new TNFi use.Results.We identified 4261 unique individuals with JIA. The proportion of patients receiving TNFi increased from 8.7% in 2005 to 22.4% in 2012 (p < 0.0001). MTX use increased from 18.4% to 23.2% (p = 0.02). NSAID use decreased from 49% to 40% (p = 0.02). GC use was relatively unchanged. Following new TNFi use, the mean number of NSAID prescriptions (among prevalent users) decreased from 2.8 to 2.0 (p < 0.0001), and the mean daily GC dose (among prevalent users) decreased from 7.3 mg/day to 3.9 mg/day (p < 0.0001). Many new TNFi users (57%) had not used MTX in the previous 6 months, and only 37% had any concurrent MTX use in the 6 months following new TNFi use.Conclusion.TNFi use in the treatment of JIA increased 2- to 3-fold over the last 8 years. New TNFi use was associated with decreased NSAID and GC use. TNFi may be replacing, rather than complementing, MTX in the treatment of many patients.


1991 ◽  
Vol 541 (1) ◽  
pp. 115-120 ◽  
Author(s):  
John M. Hallenbeck ◽  
Andrew J. Dutka ◽  
Stefanie N. Vogel ◽  
Eliahu Heldman ◽  
David A. Doron ◽  
...  

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