Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Reumatologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000600543 |
Resumo: | ABSTRACT A question is raised about an increased risk of severe infection from the use of biological drugs in patients with rheumatoid arthritis. This systematic review of observational studies aimed at assessing the risk of severe infection associated with the use of anakinra, rituximab, and abatacept in patients with rheumatoid arthritis. The following databases were searched: PubMed, Science Direct, Scopus, Web of Knowledge, Scirus, Cochrane, Exerpta Medica Database, Scielo, and Lilacs up to July 2010. Severe infections were defined as those life-threatening ones in need of the use of parenteral antibiotics or of hospitalization. Longitudinal observational studies were selected without language restriction, involving adult patients diagnosed with rheumatoid arthritis and who used anakinra, rituximab, or abatacept. In four studies related to anakinra, 129 (5.1%) severe infections were related in 2896 patients, of which three died. With respect to rituximab, two studies reported 72 (5.9%) severe infections in 1224 patients, of which two died. Abatacept was evaluated in only one study in which 25 (2.4%) severe infections were reported in 1046 patients. The main site of infection for these three drugs was the respiratory tract. One possible explanation for the high frequency of severe infections associated with anakinra may be the longer follow-up time in the selected studies. The high frequency of severe infections associated with rituximab could be credited to the less strict inclusion criteria for the patients studied. Therefore, infection monitoring should be cautious in patients with rheumatoid arthritis in use of these three drugs. |
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Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studiesRheumatoid arthritis/therapyAnti-rheumatic drugs/adverse effectsInfectionBiological therapy/adverse effectsReview of literature as topicABSTRACT A question is raised about an increased risk of severe infection from the use of biological drugs in patients with rheumatoid arthritis. This systematic review of observational studies aimed at assessing the risk of severe infection associated with the use of anakinra, rituximab, and abatacept in patients with rheumatoid arthritis. The following databases were searched: PubMed, Science Direct, Scopus, Web of Knowledge, Scirus, Cochrane, Exerpta Medica Database, Scielo, and Lilacs up to July 2010. Severe infections were defined as those life-threatening ones in need of the use of parenteral antibiotics or of hospitalization. Longitudinal observational studies were selected without language restriction, involving adult patients diagnosed with rheumatoid arthritis and who used anakinra, rituximab, or abatacept. In four studies related to anakinra, 129 (5.1%) severe infections were related in 2896 patients, of which three died. With respect to rituximab, two studies reported 72 (5.9%) severe infections in 1224 patients, of which two died. Abatacept was evaluated in only one study in which 25 (2.4%) severe infections were reported in 1046 patients. The main site of infection for these three drugs was the respiratory tract. One possible explanation for the high frequency of severe infections associated with anakinra may be the longer follow-up time in the selected studies. The high frequency of severe infections associated with rituximab could be credited to the less strict inclusion criteria for the patients studied. Therefore, infection monitoring should be cautious in patients with rheumatoid arthritis in use of these three drugs.Sociedade Brasileira de Reumatologia2016-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000600543Revista Brasileira de Reumatologia v.56 n.6 2016reponame:Revista Brasileira de Reumatologia (Online)instname:Sociedade Brasileira de Reumatologia (SBR)instacron:SBR10.1016/j.rbre.2016.10.001info:eu-repo/semantics/openAccessCabral,Vanderlea PoeysAndrade,Carlos Augusto Ferreira dePassos,Sonia Regina LambertMartins,Maria de Fátima MoreiraHökerberg,Yara Hahr Marqueseng2016-12-15T00:00:00Zoai:scielo:S0482-50042016000600543Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=0482-5004&lng=pt&nrm=isoONGhttps://old.scielo.br/oai/scielo-oai.php||sbre@terra.com.br1809-45700482-5004opendoar:2016-12-15T00:00Revista Brasileira de Reumatologia (Online) - Sociedade Brasileira de Reumatologia (SBR)false |
dc.title.none.fl_str_mv |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies |
title |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies |
spellingShingle |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies Cabral,Vanderlea Poeys Rheumatoid arthritis/therapy Anti-rheumatic drugs/adverse effects Infection Biological therapy/adverse effects Review of literature as topic |
title_short |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies |
title_full |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies |
title_fullStr |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies |
title_full_unstemmed |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies |
title_sort |
Severe infection in patients with rheumatoid arthritis taking anakinra, rituximab, or abatacept: a systematic review of observational studies |
author |
Cabral,Vanderlea Poeys |
author_facet |
Cabral,Vanderlea Poeys Andrade,Carlos Augusto Ferreira de Passos,Sonia Regina Lambert Martins,Maria de Fátima Moreira Hökerberg,Yara Hahr Marques |
author_role |
author |
author2 |
Andrade,Carlos Augusto Ferreira de Passos,Sonia Regina Lambert Martins,Maria de Fátima Moreira Hökerberg,Yara Hahr Marques |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Cabral,Vanderlea Poeys Andrade,Carlos Augusto Ferreira de Passos,Sonia Regina Lambert Martins,Maria de Fátima Moreira Hökerberg,Yara Hahr Marques |
dc.subject.por.fl_str_mv |
Rheumatoid arthritis/therapy Anti-rheumatic drugs/adverse effects Infection Biological therapy/adverse effects Review of literature as topic |
topic |
Rheumatoid arthritis/therapy Anti-rheumatic drugs/adverse effects Infection Biological therapy/adverse effects Review of literature as topic |
description |
ABSTRACT A question is raised about an increased risk of severe infection from the use of biological drugs in patients with rheumatoid arthritis. This systematic review of observational studies aimed at assessing the risk of severe infection associated with the use of anakinra, rituximab, and abatacept in patients with rheumatoid arthritis. The following databases were searched: PubMed, Science Direct, Scopus, Web of Knowledge, Scirus, Cochrane, Exerpta Medica Database, Scielo, and Lilacs up to July 2010. Severe infections were defined as those life-threatening ones in need of the use of parenteral antibiotics or of hospitalization. Longitudinal observational studies were selected without language restriction, involving adult patients diagnosed with rheumatoid arthritis and who used anakinra, rituximab, or abatacept. In four studies related to anakinra, 129 (5.1%) severe infections were related in 2896 patients, of which three died. With respect to rituximab, two studies reported 72 (5.9%) severe infections in 1224 patients, of which two died. Abatacept was evaluated in only one study in which 25 (2.4%) severe infections were reported in 1046 patients. The main site of infection for these three drugs was the respiratory tract. One possible explanation for the high frequency of severe infections associated with anakinra may be the longer follow-up time in the selected studies. The high frequency of severe infections associated with rituximab could be credited to the less strict inclusion criteria for the patients studied. Therefore, infection monitoring should be cautious in patients with rheumatoid arthritis in use of these three drugs. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000600543 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0482-50042016000600543 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.rbre.2016.10.001 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Reumatologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Reumatologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Reumatologia v.56 n.6 2016 reponame:Revista Brasileira de Reumatologia (Online) instname:Sociedade Brasileira de Reumatologia (SBR) instacron:SBR |
instname_str |
Sociedade Brasileira de Reumatologia (SBR) |
instacron_str |
SBR |
institution |
SBR |
reponame_str |
Revista Brasileira de Reumatologia (Online) |
collection |
Revista Brasileira de Reumatologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Reumatologia (Online) - Sociedade Brasileira de Reumatologia (SBR) |
repository.mail.fl_str_mv |
||sbre@terra.com.br |
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1750318051488694272 |