Mitigating infection risk with immunotherapy for rheumatoid arthritis. (June 2015)

• Record Type: Journal Article
• Authors: Subesinghe, Sujith; Whittaker, Megan; Galloway, James
• Is Part Of: International journal of clinical rheumatology. Volume 10:Number 3(2015)
• Page Start: 177
• Page End: 193
• Publication Date: 2015-06
• Subjects: immunosuppression -- infection -- rheumatoid arthritis -- vaccination; Rheumatology -- Periodicals; 616.723005
• DOI: 10.2217/ijr.15.18
• Languages: English
• ISSNs: 1758-4272

Abstract

The last two decades have seen major advances in the treatment of rheumatoid arthritis, with the introduction of combination of disease-modifying antirheumatic drug strategies and the advent of biologic therapies. Accordingly, with aggressive immunosuppression, rheumatologists are required to be more alert to infection risk. Even prior to immune suppression infections are more frequent in rheumatoid arthritis and are significant contributors to morbidity and mortality. The etiology is multifactorial reflecting an interaction between immunological dysfunction, disease activity and immunosuppression. There are several steps clinicians can take to mitigate against the risk of infection: these include appropriate patient selection for aggressive treatment strategies, vaccination against preventable pathogens and utilization of lower risk drugs in at-risk subjects. This review will address these aspects of immunosuppression.