Tumor necrosis factor-α inhibitors are potent anti-rheumatic drugs, but there is evidence
that the high level of immunosuppression they provide may also lead to a higher risk
of infections. At our institution, 3 patients with inflammatory arthritis treated
with tumor necrosis factor-α inhibitors developed mycobacterial soft tissue infections
after routine hand surgery. All 3 patients required multiple surgical procedures,
inpatient hospitalizations, and prolonged antibiotic multidrug therapy to clear the
infections.
Key words
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References
- Methotrexate and early postoperative complications in patients with rheumatoid arthritis undergoing elective orthopaedic surgery.Ann Rheum Dis. 2001; 60: 214-217
- Influence of methotrexate on the frequency of postoperative infectious complications in patients with rheumatoid arthritis.J Rheumatol. 1993; 20: 1129-1132
- Survey on the perioperative use of TNF-α inhibitors in rheumatoid hand surgery.J Hand Surg. 2006; 31B: 463-464
- Do antitumor necrosis factor agents increase the risk of postoperative orthopedic infections?.Curr Opin Rheumatol. 2008; 20: 450-456
- How antirheumatic drugs protect joints from damage in rheumatoid arthritis.Arthritis Rheum. 2008; 58: 2936-2948
- Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials.JAMA. 2006; 295: 2275-2285
- Frequency of infection in patients with rheumatoid arthritis compared with controls: a population-based study.Arthritis Rheum. 2002; 46: 2287-2293
- Infection as a complication of total knee replacement arthroplasty: risk factors and treatment in sixty-seven cases.J Bone Joint Surg. 1990; 72A: 878-883
- Risk of serious bacterial infections among rheumatoid arthritis patients exposed to tumor necrosis factor alpha antagonists.Arthritis Rheum. 2007; 56: 1125-1133
- Mycobacterium other than tuberculosis (MOTT) infection: an emerging disease in infliximab-treated patients.J Infect. 2007; 55: 484-487
- Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for antitumor necrosis factor: a large retrospective study.J Rheumatol. 2007; 34: 689-695
- Accelerated wound healing in tumor necrosis factor receptor p55-deficient mice with reduced leukocyte infiltration.FASEB J. 2002; 16: 963-974
- Atypical mycobacterium infections of the upper extremity.J Hand Surg. 1994; 19A: 480-487
- Flexor tenosynovitis in the hand caused by Mycobacterium terrae.Ann Plast Surg. 1999; 42: 330-332
- The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost.Infect Control Hosp Epidemiol. 2002; 23: 183-189
Article info
Publication history
Accepted:
September 25,
2009
Received:
May 27,
2009
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2010 Published by Elsevier Inc.
