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

Öz

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 (TNFα) 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 2^nd and 3^rd 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. 

Anahtar Kelimeler

• Ankylosing Spondylitis,Anti-TNF,Rheumatoid Arthritis

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

Öz

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.

Anahtar Kelimeler

• Ankilozan Spondilit,Anti-TNF,Romatoid Artrit

Kaynakça

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