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Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

Year 2019, Volume: 9 Issue: 1, 1 - 8, 27.03.2019
https://doi.org/10.16899/gopctd.528264

Abstract

Background: Our objective in this study
is to investigate whether there is an increase in frequency of urinary
infections in patients using anti-Tumor Necrosis Factor alpha (TNF
α) compared to the patients using disease-modifying
anti-rheumatic drugs (DMARD).

Methods: 29 patients with rheumatoid arthritis (RA) and
20 patients with Ankylosing Spondylitis (AS), for whom anti-TNF agents were
initiated for the first time, and 30 healthy controls were included in the
study. Additionally, in order to reveal effects of anti-TNF medications on
development of urinary infections better, 29 RA and 20 AS patients using DMARDs
were also included in the study.

Result: There was no significant difference in regard
to frequency of development of urinary infections between patients with active
disease before anti-TNF treatment for whom initiation of anti-TNF treatment was
considered and the patients without active disease who were using DMARDs,
despite of differences in disease activity.
When the AS patients using anti-TNF agents and DMARDs
were compared with the healthy control group in regard to frequency of
development of urinary infections; while there was no significant difference in
the DMARD group, it was more frequently encountered in the anti-TNF group at 2nd
and 3rd visits. Anti-TNF
treatment was determined to pose an additional risk for frequency of
development of urinary infections compared to DMARD treatment.







Conclusion: Although anti-TNF treatment is quite effective in
taking disease activity under control in RA and AS patients, it is always
necessary to be alert due to increased risk for infection. 

References

  • Referans 1. Lee DM, Weinblatt ME. Rheumatoid arthritis. The Lancet 2001; 358: 903-11.Referans 2. Braun J, Sieper J. Ankylosing spondylitis. The Lancet 2007; 369: 1379-90.Referans 3. Sonel B, Tutkak H, Düzgün N. Serum levels of IL-1beta, TNF-alpha, IL-8, and acute phase proteins in seronegative spondyloarthropathies. Joint Bone Spine 2002; 69: 463-7.Referans 4. Mansour M, Cheema GS, Naguwa SM, Greenspan A, Borchers AT, Keen CL, et al. Ankylosing spondylitis: a contemporary perspective on diagnosis and treatment. In: Seminars in arthritis and rheumatism. 2007; Elsevier; p.210-23.Referans 5. Scott D, Kingsley G. Tumor necrosis factor inhibitors for rheumatoid arthritis. New England Journal of Medicine 2006; 355: 704-12.Referans 6. Larché M, Sacre S, Foxwell B. Pathogenic role of TNFα in rheumatoid arthritis. Drug Discovery Today: Disease Mechanisms 2005; 2: 367-75.Referans 7. Strangfeld A, Listing J. Bacterial and opportunistic infections during anti-TNF therapy. Best Practice & Research Clinical Rheumatology 2006; 20: 1181-95.Referans 8. Dixon W, Symmons D, Lunt M, Watson K, Hyrich K, Silman A. Serious infection following anti–tumor necrosis factor α therapy in patients with rheumatoid arthritis: lessons from interpreting data from observational studies. Arthritis & Rheumatology 2007; 56: 2896-904.Referans 9. Furst DE. The risk of infections with biologic therapies for rheumatoid arthritis. In: Seminars in arthritis and rheumatism. 2010; Elsevier; p.327-46.Referans 10. Weinblatt ME, Keystone E, Furst DE, Kavanaugh AF, Chartash EK, Segurado OG. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Annals of the rheumatic diseases 2006; 65: 753-9.Referans 11. Doran MF, Crowson CS, Pond GR, O'Fallon WM, Gabriel SE. Predictors of infection in rheumatoid arthritis. Arthritis & Rheumatology 2002; 46: 2294-300.Referans 12. Martinez A, Pacheco-Tena C, Vazquez-Mellado J, Burgos-Vargas R. Relationship between disease activity and infection in patients with spondyloarthropathies. Annals of the rheumatic diseases 2004; 63: 1338-40.Referans 13. Lange U, Teichmann J. Ankylosing spondylitis and genitourinary infection. European journal of medical research 1999; 4: 1-7.Referans 14. Hjardem E, Østergaard M, Pødenphant J, Tarp U, Andersen LS, Bing J, et al. Do rheumatoid arthritis patients in clinical practice benefit from switching from infliximab to a second tumor necrosis factor alpha inhibitor? Annals of the rheumatic diseases 2007; 66: 1184-9.Referans 15. Raychaudhuri SP, Nguyen CT, Raychaudhuri SK, Gershwin ME. Incidence and nature of infectious disease in patients treated with anti-TNF agents. Autoimmunity reviews 2009; 9: 67-81.Referans 16. Guignard S, Gossec L, Salliot C, Ruyssen-Witrand A, Luc M, Duclos M, et al. Efficacy of tumour necrosis factor blockers in reducing uveitis flares in patients with spondylarthropathy: a retrospective study. Annals of the rheumatic diseases 2006; 65: 1631-4.Referans 17. Diaz-Borjon A, Weyand CM, Goronzy JJ. Treatment of chronic inflammatory diseases with biologic agents: Opportunities and risks for the elderly. Experimental gerontology 2006; 41: 1250-5.

Romatoid Artrit ve Ankilozan Spondilitli Hastalarda Anti-TNF İlaç Kullanımının Üriner Enfeksiyon Gelişimine Etkisi

Year 2019, Volume: 9 Issue: 1, 1 - 8, 27.03.2019
https://doi.org/10.16899/gopctd.528264

Abstract

Amaç: Bu çalışmada hedefimiz, anti-Tümör Nekroz Faktörü alfa (TNFa) kullanan hastalarda hastalık modifiye edici anti-romatizmal ilaçlar (DMARD) kullanan hastalarla karşılaştırıldığında idrar enfeksiyonlarının sıklığında bir artış olup olmadığını araştırmaktır.

Yöntemler: Anti-TNF ajanlarının ilk kez başlatıldığı 29 romatoid artritli (RA) hasta ve 20 adet Ankylosing Spondylitis (AS) hasta ve 30 sağlıklı kontrol çalışmaya dahil edildi. Ek olarak, anti-TNF ilaçlarının idrar enfeksiyonlarının gelişimi üzerindeki etkilerini daha iyi ortaya çıkarmak için DMARD kullanan 29 RA ve 20 AS hastası çalışmaya dahil edildi.

Bulgular: Anti-TNF tedavisine başlamadan önce aktif hastalığı olan ve anti-TNF tedavisine başlanan hastalar ile DMARD kullanan hastalar arasında üriner enfeksiyon gelişim sıklığı bakımından farklılıklara rağmen anlamlı bir fark yoktu. hastalık aktivitesinde. Anti-TNF ajanları ve DMARD kullanan AS hastaları idrar enfeksiyonlarının gelişim sıklığı açısından sağlıklı kontrol grubu ile karşılaştırıldığında; DMARD grubunda anlamlı bir fark bulunmazken, 2. ve 3. ziyaretlerde anti-TNF grubunda daha sık rastlandı. Anti-TNF tedavisinin, DMARD tedavisine kıyasla idrar yolu enfeksiyonlarının gelişme sıklığı için ek bir risk oluşturduğu tespit edildi.

Sonuç: Anti-TNF tedavisi, RA ve AS hastalarında hastalık aktivitesini kontrol altında tutma konusunda oldukça etkili olsa da, enfeksiyon riskindeki artış nedeniyle daima dikkatli olmak gerekir.

References

  • Referans 1. Lee DM, Weinblatt ME. Rheumatoid arthritis. The Lancet 2001; 358: 903-11.Referans 2. Braun J, Sieper J. Ankylosing spondylitis. The Lancet 2007; 369: 1379-90.Referans 3. Sonel B, Tutkak H, Düzgün N. Serum levels of IL-1beta, TNF-alpha, IL-8, and acute phase proteins in seronegative spondyloarthropathies. Joint Bone Spine 2002; 69: 463-7.Referans 4. Mansour M, Cheema GS, Naguwa SM, Greenspan A, Borchers AT, Keen CL, et al. Ankylosing spondylitis: a contemporary perspective on diagnosis and treatment. In: Seminars in arthritis and rheumatism. 2007; Elsevier; p.210-23.Referans 5. Scott D, Kingsley G. Tumor necrosis factor inhibitors for rheumatoid arthritis. New England Journal of Medicine 2006; 355: 704-12.Referans 6. Larché M, Sacre S, Foxwell B. Pathogenic role of TNFα in rheumatoid arthritis. Drug Discovery Today: Disease Mechanisms 2005; 2: 367-75.Referans 7. Strangfeld A, Listing J. Bacterial and opportunistic infections during anti-TNF therapy. Best Practice & Research Clinical Rheumatology 2006; 20: 1181-95.Referans 8. Dixon W, Symmons D, Lunt M, Watson K, Hyrich K, Silman A. Serious infection following anti–tumor necrosis factor α therapy in patients with rheumatoid arthritis: lessons from interpreting data from observational studies. Arthritis & Rheumatology 2007; 56: 2896-904.Referans 9. Furst DE. The risk of infections with biologic therapies for rheumatoid arthritis. In: Seminars in arthritis and rheumatism. 2010; Elsevier; p.327-46.Referans 10. Weinblatt ME, Keystone E, Furst DE, Kavanaugh AF, Chartash EK, Segurado OG. Long term efficacy and safety of adalimumab plus methotrexate in patients with rheumatoid arthritis: ARMADA 4 year extended study. Annals of the rheumatic diseases 2006; 65: 753-9.Referans 11. Doran MF, Crowson CS, Pond GR, O'Fallon WM, Gabriel SE. Predictors of infection in rheumatoid arthritis. Arthritis & Rheumatology 2002; 46: 2294-300.Referans 12. Martinez A, Pacheco-Tena C, Vazquez-Mellado J, Burgos-Vargas R. Relationship between disease activity and infection in patients with spondyloarthropathies. Annals of the rheumatic diseases 2004; 63: 1338-40.Referans 13. Lange U, Teichmann J. Ankylosing spondylitis and genitourinary infection. European journal of medical research 1999; 4: 1-7.Referans 14. Hjardem E, Østergaard M, Pødenphant J, Tarp U, Andersen LS, Bing J, et al. Do rheumatoid arthritis patients in clinical practice benefit from switching from infliximab to a second tumor necrosis factor alpha inhibitor? Annals of the rheumatic diseases 2007; 66: 1184-9.Referans 15. Raychaudhuri SP, Nguyen CT, Raychaudhuri SK, Gershwin ME. Incidence and nature of infectious disease in patients treated with anti-TNF agents. Autoimmunity reviews 2009; 9: 67-81.Referans 16. Guignard S, Gossec L, Salliot C, Ruyssen-Witrand A, Luc M, Duclos M, et al. Efficacy of tumour necrosis factor blockers in reducing uveitis flares in patients with spondylarthropathy: a retrospective study. Annals of the rheumatic diseases 2006; 65: 1631-4.Referans 17. Diaz-Borjon A, Weyand CM, Goronzy JJ. Treatment of chronic inflammatory diseases with biologic agents: Opportunities and risks for the elderly. Experimental gerontology 2006; 41: 1250-5.
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Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research
Authors

Mehmet Ali Uçar

Mehmet Sayarlıoğlu

Publication Date March 27, 2019
Acceptance Date March 14, 2019
Published in Issue Year 2019 Volume: 9 Issue: 1

Cite

APA Uçar, M. A., & Sayarlıoğlu, M. (2019). Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. Çağdaş Tıp Dergisi, 9(1), 1-8. https://doi.org/10.16899/gopctd.528264
AMA Uçar MA, Sayarlıoğlu M. Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. J Contemp Med. March 2019;9(1):1-8. doi:10.16899/gopctd.528264
Chicago Uçar, Mehmet Ali, and Mehmet Sayarlıoğlu. “Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients With Rheumatoid Arthritis and Ankylosing Spondylitis”. Çağdaş Tıp Dergisi 9, no. 1 (March 2019): 1-8. https://doi.org/10.16899/gopctd.528264.
EndNote Uçar MA, Sayarlıoğlu M (March 1, 2019) Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. Çağdaş Tıp Dergisi 9 1 1–8.
IEEE M. A. Uçar and M. Sayarlıoğlu, “Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis”, J Contemp Med, vol. 9, no. 1, pp. 1–8, 2019, doi: 10.16899/gopctd.528264.
ISNAD Uçar, Mehmet Ali - Sayarlıoğlu, Mehmet. “Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients With Rheumatoid Arthritis and Ankylosing Spondylitis”. Çağdaş Tıp Dergisi 9/1 (March 2019), 1-8. https://doi.org/10.16899/gopctd.528264.
JAMA Uçar MA, Sayarlıoğlu M. Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. J Contemp Med. 2019;9:1–8.
MLA Uçar, Mehmet Ali and Mehmet Sayarlıoğlu. “Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients With Rheumatoid Arthritis and Ankylosing Spondylitis”. Çağdaş Tıp Dergisi, vol. 9, no. 1, 2019, pp. 1-8, doi:10.16899/gopctd.528264.
Vancouver Uçar MA, Sayarlıoğlu M. Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis. J Contemp Med. 2019;9(1):1-8.