Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis

Khaldoon M Alawneh,1 Mahmoud H Ayesh,1 Basheer Y Khassawneh,1 Salwa Shihadeh Saadeh,1 Mahmoud Smadi,2 Khaldoun Bashaireh31Department of Medicine, College of Medicine, King Abdullah University Hospital, 2College of Science, 3Department of Special Surgery, College of Medicine, King Abdullah Universit...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Alawneh KM, Ayesh MH, Khassawneh BY, Saadeh SS, Smadi M, Bashaireh K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/e8d093d7391445aeb1b5eae02e36bfc9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:e8d093d7391445aeb1b5eae02e36bfc9
record_format	dspace
spelling	oai:doaj.org-article:e8d093d7391445aeb1b5eae02e36bfc92021-12-02T06:15:48ZAnti-TNF therapy in Jordan: a focus on severe infections and tuberculosis1177-5475https://doaj.org/article/e8d093d7391445aeb1b5eae02e36bfc92014-04-01T00:00:00Zhttp://www.dovepress.com/anti-tnf-therapy-in-jordan-a-focus-on-severe-infections-and-tuberculos-a16527https://doaj.org/toc/1177-5475 Khaldoon M Alawneh,1 Mahmoud H Ayesh,1 Basheer Y Khassawneh,1 Salwa Shihadeh Saadeh,1 Mahmoud Smadi,2 Khaldoun Bashaireh31Department of Medicine, College of Medicine, King Abdullah University Hospital, 2College of Science, 3Department of Special Surgery, College of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, JordanBackground: A high rate of infection has been reported in patients receiving treatment with anti-tumor necrosis factor (anti-TNF). This study describes the rate of and risk factors for serious infections in patients receiving anti-TNF agents in Jordan.Methods: This retrospective observational study was conducted at a large tertiary referral center in the north of Jordan. Between January 2006 and January 2012, 199 patients who received an anti-TNF agent (infliximab, adalimumab, or etanercept) were included. Patients received the anti-TNF treatment for rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, or other conditions. A serious infection was defined as any bacterial, viral, or fungal infection that required hospitalization, administration of appropriate intravenous antimicrobial therapy, and temporary withholding of anti-TNF treatment.Results: The mean duration of anti-TNF treatment was 26.2 months. Steroids were used in 29.1% of patients, while 54.8% were given additional immunosuppressant therapy (methotrexate or azathioprine). Only one anti-TNF agent was given in 70.4% of patients, while 29.6% received different anti-TNF agents for the duration of treatment. Serious infections were documented in 39 patients (19.6%), including respiratory tract infections (41%), urinary tract infections (30.8%), and skin infections (20.5%), and extrapulmonary tuberculosis in three patients (7.7%). Exposure to more than one anti-TNF agent was the only factor associated with a significant increase in the rate of infection (relative risk 1.9, 95% confidence interval 1.06–4.0, P=0.03).Conclusion: Serious infections, including tuberculosis, were a common problem in patients receiving anti-TNF agents, and exposure to more than one anti-TNF agent increased the risk of serious infection.Keywords: anti-tumor necrosis factor therapy, biologics, developing world, extra-pulmonary tuberculosis, immune mediated diseasesAlawneh KMAyesh MHKhassawneh BYSaadeh SSSmadi MBashaireh KDove Medical PressarticleMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol 2014, Iss default, Pp 193-198 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Alawneh KM Ayesh MH Khassawneh BY Saadeh SS Smadi M Bashaireh K Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis
description	Khaldoon M Alawneh,1 Mahmoud H Ayesh,1 Basheer Y Khassawneh,1 Salwa Shihadeh Saadeh,1 Mahmoud Smadi,2 Khaldoun Bashaireh31Department of Medicine, College of Medicine, King Abdullah University Hospital, 2College of Science, 3Department of Special Surgery, College of Medicine, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, JordanBackground: A high rate of infection has been reported in patients receiving treatment with anti-tumor necrosis factor (anti-TNF). This study describes the rate of and risk factors for serious infections in patients receiving anti-TNF agents in Jordan.Methods: This retrospective observational study was conducted at a large tertiary referral center in the north of Jordan. Between January 2006 and January 2012, 199 patients who received an anti-TNF agent (infliximab, adalimumab, or etanercept) were included. Patients received the anti-TNF treatment for rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease, or other conditions. A serious infection was defined as any bacterial, viral, or fungal infection that required hospitalization, administration of appropriate intravenous antimicrobial therapy, and temporary withholding of anti-TNF treatment.Results: The mean duration of anti-TNF treatment was 26.2 months. Steroids were used in 29.1% of patients, while 54.8% were given additional immunosuppressant therapy (methotrexate or azathioprine). Only one anti-TNF agent was given in 70.4% of patients, while 29.6% received different anti-TNF agents for the duration of treatment. Serious infections were documented in 39 patients (19.6%), including respiratory tract infections (41%), urinary tract infections (30.8%), and skin infections (20.5%), and extrapulmonary tuberculosis in three patients (7.7%). Exposure to more than one anti-TNF agent was the only factor associated with a significant increase in the rate of infection (relative risk 1.9, 95% confidence interval 1.06–4.0, P=0.03).Conclusion: Serious infections, including tuberculosis, were a common problem in patients receiving anti-TNF agents, and exposure to more than one anti-TNF agent increased the risk of serious infection.Keywords: anti-tumor necrosis factor therapy, biologics, developing world, extra-pulmonary tuberculosis, immune mediated diseases
format	article
author	Alawneh KM Ayesh MH Khassawneh BY Saadeh SS Smadi M Bashaireh K
author_facet	Alawneh KM Ayesh MH Khassawneh BY Saadeh SS Smadi M Bashaireh K
author_sort	Alawneh KM
title	Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis
title_short	Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis
title_full	Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis
title_fullStr	Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis
title_full_unstemmed	Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis
title_sort	anti-tnf therapy in jordan: a focus on severe infections and tuberculosis
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/e8d093d7391445aeb1b5eae02e36bfc9
work_keys_str_mv	AT alawnehkm antitnftherapyinjordanafocusonsevereinfectionsandtuberculosis AT ayeshmh antitnftherapyinjordanafocusonsevereinfectionsandtuberculosis AT khassawnehby antitnftherapyinjordanafocusonsevereinfectionsandtuberculosis AT saadehss antitnftherapyinjordanafocusonsevereinfectionsandtuberculosis AT smadim antitnftherapyinjordanafocusonsevereinfectionsandtuberculosis AT bashairehk antitnftherapyinjordanafocusonsevereinfectionsandtuberculosis
_version_	1718400025127550976

Anti-TNF therapy in Jordan: a focus on severe infections and tuberculosis

Ejemplares similares