GÜLAY OKAY, ELMAS BİBERCİ KESKİN
Southern Clinics of Istanbul Eurasia - 2021;32(1):19-24
INTRODUCTION: Biologic agents can provide effective control of disease activity in patients with chronic inflammatory disease (CID), however, they are associated with an increased risk of serious infection. The aim of this study was to investigate the risk and distribution of serious infection, the rate of vaccination, and the screening tests recommended in patients treated with biologic agents. METHODS: Patients with CID who were given biologic agent therapy were retrospectively evaluated. Hepatitis and tuberculosis (TB) screening tests, the vaccinations administered, risk factors for and the rate of serious infection were reviewed. Results: Of the 320 patients included in the study, 58% were male and the mean age was 44.5 years (±12.2 years). The biologic agent used was infliximab in 108 patients (33.8%), adalimumab in 115 (35.9%), etanercept in 61 (19.1%), ustekinumab in 19 (5.9%), certolizumab in 9 (2.8%), golimumab in 5 (1.6%), and secukinumab in 3 (0.9%). The hepatitis B, pneumococcal, influenza, and hepatitis A vaccination rate in patients with CID was 82.9%, 12.5%, 11.6%, and 4%, respectively. The tuberculin skin test was preferred for 33.4% of the patients for TB screening, while the QuantiFERON-TB Gold test (Qiagen NV, Hilden, Germany) was used in 79%. A total of 25 (7.8%) cases of serious infection occurred, and the most common sites were the respiratory tract (28%) and the urinary tract (28%). Binary logistic regression analysis showed that the risk of infection was significantly higher in patients who had chronic obstructive pulmonary disease (COPD) and those who used azathioprine. DISCUSSION AND CONCLUSION: The most common sites of infection were the respiratory tract and the urinary tract, and the risk of infection was significantly higher in patients who had COPD and those who used azathioprine. The rate of vaccination was lower than has been recommended. Awareness of hepatitis B and TB reactivation risk in patients treated with biologic agents was greater than awareness of the risk of other infections.
