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The frequency of infections in patients with juvenile idiopathic arthritis on biologic agents: 1-year prospective study

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Abstract

Introduction

The most effective and concurrently the safest treatment regimen selection is important to provide early control of juvenile idiopathic arthritis (JIA) and to have an acceptable quality of life. The effectivity of biologic agents as well as standard disease-modifying drugs is well documented in treatment of JIA. In spite of their high benefit, these drugs have the risk of serious infections. Herein, we conducted a prospective study to investigate the infectious complications of biologic agents in patients diagnosed with JIA.

Methods

Patients on biologic treatment regimen were examined by the pediatric infectious disease specialist in every 2 months during 1-year long.

Results

Throughout the study period, 57% (n:175) of the patients developed infection and 43% (n:132) of them completed this period without any infection. Upper respiratory tract infections which were treated in outpatient clinic were the most common infection. Only three serious infections (two pneumonia, one pleural effusion), which required hospitalization, developed. The infection rate was highest in systemic JIA and lowest in enthesitis-related arthritis (p < 0.001). The total rate of infection development after 1-year period was lowest for etanercept; it was highest for the patients on infliximab treatment (p < 0.001).

Conclusion

We comment that the altered immune system of JIA can be responsible from the serious infections irrespective of immunosuppressive therapy. Biologic agents can be safely used in JIA evaluating the loss and benefit statement.

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Authors and Affiliations

  1. Department of Pediatric Infectious Disease, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey

    Deniz Aygun, Haluk Cokugras & Yıldız Camcıoglu

  2. Department of Pediatric Rheumatology, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey

    Sezgin Sahin, Amra Adrovic, Kenan Barut & Ozgur Kasapcopur

Authors
  1. Deniz Aygun
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  2. Sezgin Sahin
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  3. Amra Adrovic
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  4. Kenan Barut
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  5. Haluk Cokugras
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  6. Yıldız Camcıoglu
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  7. Ozgur Kasapcopur
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Corresponding author

Correspondence to Ozgur Kasapcopur.

Ethics declarations

The study protocol was in line with the guidelines of the 1975 Declaration of Helsinki. Ethics Committee approval was obtained from Faculty Local Ethics Committee (367966). Written informed consents were taken from all parents before commencing this study.

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Aygun, D., Sahin, S., Adrovic, A. et al. The frequency of infections in patients with juvenile idiopathic arthritis on biologic agents: 1-year prospective study. Clin Rheumatol 38, 1025–1030 (2019). https://doi.org/10.1007/s10067-018-4367-9

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  • DOI: https://doi.org/10.1007/s10067-018-4367-9

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