Connect with others who understand.

sign up log in
Resources
About MyPsoriasisTeam

Connect with others who understand.

sign up log in
Resources
About MyPsoriasisTeam
PSORIASIS
NEWS

Serious Infection Risks Lower for People With Psoriatic Arthritis Than Rheumatoid Arthritis After TNF Inhibitor Treatment

Posted on December 24, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Aminah Wali, Ph.D.

  • Tumor necrosis factor (TNF) inhibitors — a type of biologic — are effective treatments for rheumatoid arthritis (RA) and psoriatic arthritis (PsA), but they can increase the risk of serious infection.
  • People with RA are more likely than people with PsA to have a serious infection following treatment with TNF inhibitors, according to a recent study.
  • Risk factors among people with RA, including more frequent use of prednisolone, may contribute to the increased risk of infection, researchers noted.

Following TNF inhibitor treatment, people with RA develop serious infections at nearly twice the rate as those with PsA, according to a recent research study. The findings may help guide health care providers in how they prescribe TNF inhibitors — a type of biologic — for people with different types of rheumatological conditions.

The study was published in Annals of the Rheumatic Diseases and used data collected by the NORwegian-Disease Modifying Anti-Rheumatic Drug (NOR-DMARD) registry, a large collection of information about responses to drug treatments over time.

RA and PsA are both forms of arthritis, an autoimmune disease that affects the joints. Autoimmune diseases arise when the immune system, which normally protects the body from infection, malfunctions and attacks the body’s own tissues. Whereas RA isn’t always linked to another disease, PsA specifically occurs in people with psoriasis.

Response to TNF Inhibitors

Rheumatoid arthritis and psoriatic arthritis may be treated with a class of drugs called tumor necrosis factor inhibitors, which helps to prevent the autoimmune response by making the immune system weaker. While this alleviates symptoms of arthritis, TNF inhibitors can increase the chance of serious infections, such as gastrointestinal (GI) and subcutaneous tissue (the deepest layer of skin) infections.

Examples of TNF inhibitors used to treat psoriatic arthritis include Cimzia (certolizumab pegol), Enbrel (etanercept), and Humira (adalimumab). The research study does not identify specific TNF inhibitors used to treat RA or PsA.

Researchers sought to determine whether one form of arthritis had a higher risk of serious infection after using TNF inhibitors compared to the other. To perform this comparison, the research team used information collected by the NOR-DMARD between 2009 and 2018 that looked at how people with RA and PsA responded to TNF inhibitors.

The treatment data from the NOR-DMARD was then connected to the Norwegian Patient Registry and the Norwegian Cause of Death Registry to identify people who had had a serious infection — a diagnosed infection that resulted in a hospital stay or death.

The study found that, across the same age and gender, people with PsA were less likely than people with RA to have a serious infection at 12 and 24 months after starting treatment with TNF inhibitors. The incidence rate for serious infections was significantly lower in people with PsA (2.16) compared to the rate in people with RA (4.17). Incidence rates are the total number of cases in a given time period divided by the total number of persons in the population.

The study presents an important finding regarding risk of serious infection among people in treatment for PsA, which has not been as well studied as RA. The conclusion is further supported by the use of real clinical data collected from several hospitals.

Researchers suggested reasons why people with RA may be at higher risk of developing infections after TNF inhibitor treatment. “The additive effect of multiple risk factors in the RA population, including more frequent prednisolone use, may explain some of the increased risk of [serious infections] in patients with RA. Another explanation could be the RA disease itself, through disease-related alterations in host defence.”

The authors noted, however, that the study results “need to be interpreted with caution given the many important differences between the RA and PsA population,” including possible effects from other medications people may take.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Aminah Wali, Ph.D. received her doctorate in genetics and molecular biology from the University of North Carolina at Chapel Hill. Learn more about her here.

Related articles

Psoriasis on the scalp is common for those with psoriasis. Discover whether products like Sea Breeze can help with scalp psoriasis.

Does Sea Breeze Help Scalp Psoriasis?

Psoriasis on the scalp is common for those with psoriasis. Discover whether products like Sea Breeze can help with scalp psoriasis.
If you’re living with psoriasis, you may wonder how your diet affects your skin. Chicken, a...

Is Chicken Good for Psoriasis, or Does It Trigger Flares?

If you’re living with psoriasis, you may wonder how your diet affects your skin. Chicken, a...
If you’re one of the 6.5 million Americans living with psoriasis, you may be considering natural...

Does Using a Coffee Scrub Work for Psoriasis?

If you’re one of the 6.5 million Americans living with psoriasis, you may be considering natural...
The psychological and social impacts of plaque psoriasis are real, and you are not alone in...

How To Explain Your Plaque Psoriasis to Others

The psychological and social impacts of plaque psoriasis are real, and you are not alone in...
Plaque psoriasis is usually worse in cold, dry weather, but some people notice their symptoms get...

Can Plaque Psoriasis Get Worse in the Summer? How To Prepare

Plaque psoriasis is usually worse in cold, dry weather, but some people notice their symptoms get...
Some people with psoriasis find that eating different foods triggers their skin condition. Others...

Is Peanut Butter Good or Bad for Psoriasis?

Some people with psoriasis find that eating different foods triggers their skin condition. Others...

Recent articles

Dead Sea salt can be an effective over-the-counter remedy for psoriasis. Dead Sea salt is often...

Does Dead Sea Salt Help Psoriasis?

Dead Sea salt can be an effective over-the-counter remedy for psoriasis. Dead Sea salt is often...
Psoriatic arthritis (PsA) is characterized by joint pain, swelling, and stiffness.A...

Psoriatic Arthritis Symptoms

Psoriatic arthritis (PsA) is characterized by joint pain, swelling, and stiffness.A...
About 30 percent of people with psoriasis will eventually be diagnosed with psoriatic arthritis...

Psoriatic Arthritis in the Hands: Symptoms and Treatment Options

About 30 percent of people with psoriasis will eventually be diagnosed with psoriatic arthritis...
Many people with psoriasis have trouble sticking to their treatment plan, which can lead to poor...

Five Tips for Sticking With Your Psoriasis Treatment

Many people with psoriasis have trouble sticking to their treatment plan, which can lead to poor...
The Centers for Disease Control and Prevention (CDC) has approved a second COVID-19 booster shot...

What People With Psoriasis Should Know About Getting a Second COVID-19 Booster Shot

The Centers for Disease Control and Prevention (CDC) has approved a second COVID-19 booster shot...
Some people with psoriasis find that certain factors can trigger flares (periods of worsening...

Psoriasis and Hormones: How Hormonal Changes Can Affect You

Some people with psoriasis find that certain factors can trigger flares (periods of worsening...
psoriasis News
psoriasis News

Thank you for subscribing!

Become a member to get even more:

sign up for free

close