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The frequency and structure of comorbid infections in patients with spondyloarthritis (preliminary own data)

https://doi.org/10.21518/2079-701X-2021-2-122-126

Abstract

Introduction. Data on the frequency of comorbid infections (CI) in patients with spondyloarthritis (SpA) are few and contradictory. Objective. The aim of the study was to study the frequency and structure of CI in the inpatient population of SpA patients in the course of a one-moment retrospective study.
Subjects and methods. The study included 205 patients with SPA: 119 men, 86 women, the age of patients was 39.02 ± 12.2 years, the duration of the disease was 129.3 ± 104.3 months. Ankylosing spondylitis was diagnosed in 133 patients, psoriatic arthritis in 55, spondyloarthritis associated with Crohn’s disease – in 1, undifferentiated spondyloarthritis – in 16. Most patients, along with nonsteroidal anti-inflammatory drugs, received glucocorticoids, basic anti-inflammatory drugs, and biological drugs. Patients were interviewed by a research doctor with the completion of a unified questionnaire, additional data were obtained from medical documentation.
Results. 20% of patients reported more frequent CI development after the SpA debut. 28.7% of patients reported a more severe course of previously observed CI. Temporary discontinuation of therapy due to the development of CI occurred in 25.4% of patients. Exacerbation of SpA after CI was diagnosed in 40% of patients. In general, the leading place in the structure of CI was occupied by infections of the respiratory tract and ENT-organs, the second place belonged to herpes-viral infections. Serious CI accounted for 6.8% of all cases of CI. In SpA patients receiving immunosuppressive therapy, there was an increase in the frequency of acute nasopharyngitis, sinusitis, acute bronchitis, pneumonia and herpes-viral infections. However, cases of CI have also been reported in patients who have never received immuno-suppressive drugs.
Conclusion. The data obtained indicate the important of the problem of CI in SpA. Further studies are needed on large samples of patients in order to find significant risk factors for CI, study their relationship with clinical characteristics and influence on the course of SpA.

About the Authors

M. M. Baranova
Nasonova Research Institute of Rheumatology
Russian Federation

Marina M. Baranova, Postgraduate Student of Laboratory for the Study of Comorbid Infections and Monitoring of Drug Therapy Safety

34а, Kashirskoe Shosse, Moscow, 115522



N. V. Muravyeva
Nasonova Research Institute of Rheumatology
Russian Federation

Natalia V. Muravyeva, Cand. of Sci. (Med.), Research Associate of Laboratory for the Study of Comorbid Infections and Monitoring of Drug Therapy Safety

34а, Kashirskoe Shosse, Moscow, 115522



B. S. Belov
Nasonova Research Institute of Rheumatology
Russian Federation

Boris S. Belov, Dr. of Sci. (Med.), Head of Laboratory for the Study of Comorbid Infections and Monitoring of Drug Therapy Safety

34а, Kashirskoe Shosse, Moscow, 115522



References

1. Belov B.S., Karateev A.E. COVID-19: a new challenge for rheumatologists. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2020;14(2):110–116. (In Russ.) doi: 10.14412/1996-7012-2020-2-110-116.

2. Lila A.M., Olyunin Yu.A., Gordeev A.V. Assessment of the status of patients with rheumatoid arthritis. Current trends. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2020;14(2):7–13. (In Russ.) doi: 10.14412/1996-70122020-2-7-13.

3. Belov B.S., Tarasova G.M., Bukhanova D.V. Comorbid infections in rheumatic diseases. Antibiotiki i khimioterapiya = Antibiotics and Chemotherapy. 2019;64(1–2):50–57. (In Russ.) doi: 10.24411/0235W2990W2019W10009.

4. Belov B.S., Naumtseva M.S., Tarasova G.M., Bukhanova D.V. Biological therapy and infection in rheumatoid arthritis patients: modern aspects. Meditsinsky sovet = Medical Council. 2016;(11):106–116. (In Russ.) doi: 10.21518/2079-701X-2016-11-106-116.

5. Belov B.S., Tarasova G.M., Bukhanova D.V. Infectious comorbidities in patients with rheumatoid arthritis: Status praesens. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2019;13(3):102–108. (In Russ.) doi: 10.14412/1996-7012-2019-3-102-108.

6. Belov B.S., Bukhanova D.V., Tarasova G.M. Lower respiratory tract infections in rheumatic diseases. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2018;12(1):47–54. (In Russ.) doi: 10.14412/1996-7012-2018-1-47-54.

7. Bukhanova D.V., Belov B.S., Tarasova G.M., Soloviev S.K., Ananyeva L.P., Popkova T.V. et al. Comorbid infections in rheumatic diseases (according to FCIB named after V.A. Nasonova). Meditsinsky sovet = Medical Council. 2019;(9):86–91. (In Russ.) doi: 10.21518/2079-701X-2019-9-86-91.

8. Minozzi S., Bonovas S., Lytras T., Pecoraro V., González-Lorenzo M., Bastiampillai A.J. et al. Risk of infections using anti-TNF agents in rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: a systematic review and meta-analysis. Exp Opin Drug Saf. 2016;15(1S):11–34. doi: 10.1080/14740338.2016.1240783.

9. Fouque-Aubert A., Jette-Paulin L., Combescure C., Basch A., Tebib J., Gossec L. Serious infections in patients with ankylosing spondylitis with and without TNF blockers: a systematic review and meta-analysis of randomised placebo-controlled trials. Ann Rheum Dis. 2010;69(10):1756–1761. doi: 10.1136/ard.2008.098822.

10. Wang S., He Q., Shuai Z. Risk of serious infection in biological treatment of patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis. Clin Rheumatol. 2018;37(2):439–450. doi: 10.1007/s10067-017-3966-1.

11. Wronski J., Fiedor P. The safety profile of tumor necrosis factor inhibitors in ankylosing spondylitis: are TNF inhibitors safer than we thought? J Clin Pharmacol. 2019;59(4):1–18. doi: 10.1002/jcph.1348.

12. Wallis D., Thavaneswaran A., Haroon N., Ayearst R., Inman R.D. Tumour necrosis factor inhibitor therapy and infection risk in axial spondyloarthritis: results from a longitudinal observational cohort. Rheumatology (Oxford). 2015;54(1):152–156. doi: 10.1093/rheumatology/keu255.

13. Combe B., Rahman P., Kameda H., Cañete J.D., Gallo G., Agada N. et al. Safety results of ixekizumab with 1822.2 patient-years of exposure: an integrated analysis of 3 clinical trials in adult patients with psoriatic arthritis. Arthritis Res Ther. 2020;22(1):14. doi: 10.1186/s13075-020-2099-0.

14. Atzeni F., Sarzi-Puttini P., Sebastiani M., Panetta V., Salaffi F., Iannone F. et al. Rate of serious infections in spondyloarthropathy patients treated with anti-tumour necrosis factor drugs: a survey from the Italian registry GISEA. Clin Exp Rheumatol. 2019;37(4):649–655. Available at: https://pubmed.ncbi.nlm.nih.gov/30767865.

15. Chung H.Y., Tam L.S., Chan S.C.W., Cheung J.P.Y., Wong P.Y., Ciang C.O. et al. Risk of community-acquired pneumonia requiring hospitalization in patients with spondyloarthritis. Ther Adv Musculoskelet Dis. 2020;12:1759720X20962618. doi: 10.1177/1759720X20962618.

16. Cecconi M., Ranza R., Titton D.C., Moraes J.C.B., Bertolo M., Bianchi W. et al. Incidence of infectious adverse events in patients with rheumatoid arthritis and spondyloarthritis on biologic drugs – data from the Brazilian Registry for Biologics Monitoring. J Clin Rheumatol. 2020;26(2):73–78. doi: 10.1097/RHU.0000000000000935.

17. Xu Z., Xu P., Fan W., Yang G., Wang J., Cheng Q., Yu M. Risk of infection in patients with spondyloarthritis and ankylosing spondylitis receiving antitumor necrosis factor therapy: A meta-analysis of randomized controlled trials. Exp Ther Med. 2017;14(4):3491–3500. doi: 10.3892/etm.2017.5003.

18. Burmester G.R., Gordon K.B., Rosenbaum J.T., Arikan D., Lau W.L., Li P. et al. Long-term safety of adalimumab in 29,967 adult patients from global clinical trials across multiple indications: an updated analysis. Adv Ther. 2020;37(1):364–380. doi: 10.1007/s12325-019-01145-8.

19. Muravyeva N.V., Belov B.S., Baranova M.M., Korotaeva T.V. Comorbid infections in spondyloarthritis: a modern view of the problem. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2020;14(4):103–110. (In Russ.) doi: 10.14412/1996-7012-2020-4-103-110.

20. Wong S.C.T., Li I.W.S., Ng A.H.Y., Lau C.S., Chung H.Y. Risk of cutaneous herpes zoster in patients with spondyloarthritis treated with conventional and biologic disease-modifying antirheumatic drugs. Int J Rheum Dis. 2020;23(2):189–196. doi: 10.1111/1756-185X.13694.

21. Hagberg K.W., Persson R., Vasilakis-Scaramozza C., Niemcryk S., Peng M., Paris M. et al. Herpes Zoster, hepatitis C, and tuberculosis risk with apremilast compared to biologics, DMARDs and corticosteroids to treat psoriasis and psoriatic arthritis. Clin Epidemiol. 2020;12:153–161. doi: 10.2147/CLEP.S239511.

22. Lim D.H., Kim Y.J., Kim S.O., Hong S., Lee C.K., Yoo B., Kim Y.G. The risk of herpes zoster in patients with ankylosing spondylitis: analysis of the Korean National Health Insurance Service – sample cohort data-base. Mod Rheumatol. 2018;28(1):168–173. doi: 10.1080/14397595.2017.1325034.


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For citations:


Baranova MM, Muravyeva NV, Belov BS. The frequency and structure of comorbid infections in patients with spondyloarthritis (preliminary own data). Meditsinskiy sovet = Medical Council. 2021;(2):122-126. (In Russ.) https://doi.org/10.21518/2079-701X-2021-2-122-126

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