Infection Risk Up in Seniors with RA

Rheumatoid arthritis can lead to more than painful joints; it can lead to other serious health problems. If doctors know which patients are at risk, they can take steps to prevent complications.

Older patients with rheumatoid arthritis may have an increased risk of serious infections, especially if those patients are taking a certain type of steroid drug.

Ask your doctor about arthritis drugs risks and benefits.

Sasha Bernatsky, MD, FRCPC, PhD, of McGill University in Montreal, and colleagues set out to examine the risks and risk factors for serious infections in seniors with rheumatoid arthritis.

Among 86,039 older arthritis patients, there were 20,575 infections, which comes out to a rate of 46.4 infections per 1,000 person-years.

The most common infections were respiratory (lung-related) infections, shingles (herpes zoster) and skin or soft tissue infections.

Infection rates were higher among patients with a higher co-morbidity (other health problems), greater disease severity and history of previous infection. There was also an association between infection and living in a rural area.

In addition, the researchers found that patients taking TNF inhibitors and disease-modifying anti-rheumatic drugs (DMARDs) were 1.2 to 3.5 times more likely to develop a serious infection.

Patients taking low doses of glucocorticosteroids were 4.0 times more likely to develop infection. At high doses of glucocorticosteroids, the risk of infection increased 7.6-fold.

These findings suggest that seniors with rheumatoid arthritis have a significant risk of infection. According to the authors, the infection risk found in this study is greater than that found in previous studies on younger arthritis patients.

The study's results highlight that many rheumatoid arthritis drugs may boost the risk of infection, but glucocorticosteroids seem to carry an especially high risk, the authors concluded.

For their study, Dr. Bernatsky and colleagues looked at data from rheumatoid arthritis patients 66 years of age and older. They compared patients with a primary diagnosis of infection to patients with no infection.

The study was funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health and Long-Term Care Drug Innovation Fund.

The research was published July 25 in Arthritis Care & Research, a journal of the American College of Rheumatology.