Abstract

GULIN DAVILA, J.  and  GONZALEZ-GAY, M. A.. Infectious events during the first year of treatment with an antagonist of the tumor necrosis factor. Farm Hosp. [online]. 2013, vol.37, n.5, pp.351-357. ISSN 2171-8695.  https://dx.doi.org/10.7399/FH.2013.37.5.717.

Objective: To assess the incidence of severe infections in patients treated with anti-TNF-α drugs, during the first year of treatment with these drugs. Materials and method: Retrospective observational study carried out at a general hospital from a sample of patients receiving their first anti-TNF-α drug, according to approved indications, to treat a rheumatic disease. Each patient follow-up lasted for 2 years: the year before receiving the drug and the year after starting on this therapy. We considered those severe infectious events requiring hospital admission. A cohort study was performed before-after. The incidence rates of number of events (infections) per 100,000 inhabitants/year for the first treatment year and the previous year (control period) were calculated. The relative risk was calculated. Results: We included 196 patients. Twelve severe infectious events were recorded during the first treatment year, with a relative risk of 2.4. The biological drug most frequently associated to infection was Adalimumab. All patients having an infection had been previously or concomitantly treated with Methotrexate, and 90.6% with glucocorticosteroids. The main location of the infection was the respiratory system (58.3%), and the gram-positive microorganisms were the most frequent (58.3%). Conclusions: The use of anti-TNF-α drugs, and mainly Adalimumab, represents a risk factor for suffering severe infections, mainly at the respiratory tract, produced by gram-positive microorganisms. The use of immunosuppressive drugs such as Methotrexate and glucocorticosteroids seems to increase the risk for such events.

Keywords : Tumor necrosis factor; adalimumab; etanercept; infliximab; infections; tuberculosis.

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