Psoriatic arthritis patients on bio's have higher rate of infections

[Fred]

This study looked at psoriatic arthritis patients using bio treatments and concluded the rate of infection was higher than of those with just psoriasis.

Quote:

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Objective:
To investigate the rate, type, characteristics, and predictors of infection in a cohort of patients with psoriatic arthritis (PsA) and a cohort of patients with psoriasis without arthritis (PsC).

Methods:
A cohort of patients with PsA and a cohort of patients with PsC were followed according to a standard protocol and information on the occurrence of infections was recorded. The rate of infection was estimated by fitting an exponential model. A Weibull regression model was fitted to estimate the relative risk of first infection associated with a number of covariates. Risk factors for recurrent infections were investigated using generalized estimating equations.

Results:
There were 498 and 74 infections reported among 695 and 509 patients with PsA and PsC, respectively, with an incidence rate of 19.6 per 100 person-years in the PsA cohort compared with 12.2 in the PsC cohort. The HR of the time to the first infection in PsA versus PsC was 1.6 (p = 0.002), and higher in patients treated with biologics versus nonbiologics at 1.56 (95% CI 1.22–2.00) in PsA and 1.50 (95% CI 0.64–3.54) in the PsC cohorts. Female sex and treatment with biologics were associated with infection in the PsA cohort, whereas a lower Psoriasis Area and Severity Index score and a higher Functional Comorbidity Index were associated with infection in the PsC cohort. Ultraviolet treatment was protective against infection in both cohorts. No difference in rates of hospitalization was found (p = 0.66). There were no infection-related deaths in either cohort.

Conclusion:
The incidence rate of infection was higher in the PsA than the PsC cohort and higher among patients treated with biologics. The data confirm the association between infection and biologic treatment in psoriatic disease.

Source: jrheum.org

*Early view funding unknown.

[Caroline]

Interesting allthough for me all the numbers in those studies are still difficult to follow. I think I will have to dive into statistics once to get a grip of what they are telling.
Or I can ask Ionica, she is good at math.

The conclusion however walks side by side to the feeling of dr.  Van de Kerkhoff over here in the Netherlands. He is one of the leading dermatologists with much psoriasis knowledge. He also said that the risk of infections while using biologicals was higher. But he did not prove this with numbers. So I think in his practice he had seen this at least a few times.

[D Foster]

It's not only when using bio's that infection are higher when I was taking MTX for P and PsA I had quite a lot more infections than I have had on Stelara.

[Caroline]

It is also very personal perhaps. In the 12-13 years I use DMF I did not have any infection. While it still lowers the lymphocytes. So that is not the only measurement.
Biologicals work differently from MTX and again different from DMF.