There is no evidence to support the practice of suspending TNF-inhibitor use in the setting of nonserious infections, unless the symptoms or signs are suggestive of a more serious infection, Dr. Cush said.
In a meta-analysis to be presented by colleague Dr. Kathryn Dao at the upcoming European League Against Rheumatism meeting in Copenhagen, the risk for nonserious infections was increased in patients with RA who received adalimumab (odds ratio, 1.39) or infliximab (OR, 1.53), but not etanercept (OR, 0.99).
“The magnitude is small, but we have to be mindful of these very common events and how they can be properly managed in patients receiving biologics,” he said.
Dr. Cush disclosed that he has been an adviser, consultant, or lecturer for Abbott Laboratories, Centocor Inc., Pfizer Inc., Roche, UCB SA, and Wyeth.
He noted he has been a clinical investigator for or received research support from Celgene Corp., Genentech Inc., Pfizer, Roche, UCB, and the Consortium of Rheumatology Researchers of North America.
While patients need flu shots and other regular immunizations, attenuated vaccines should be avoided. DR. CUSH