Romatoid Artrit ve Ankilozan Spondilitli Hastalarda Anti-TNF İlaç Kullanımının Üriner Enfeksiyon Gelişimine Etkisi

Amaç: Bu çalışmada hedefimiz, anti-Tümör Nekroz Faktörü alfa (TNFa) kullanan hastalarda hastalık modifiye edici anti-romatizmal ilaçlar (DMARD) kullanan hastalarla karşılaştırıldığında idrar enfeksiyonlarının sıklığında bir artış olup olmadığını araştırmaktır.Yöntemler: Anti-TNF ajanlarının ilk kez başlatıldığı 29 romatoid artritli (RA) hasta ve 20 adet Ankylosing Spondylitis (AS) hasta ve 30 sağlıklı kontrol çalışmaya dahil edildi. Ek olarak, anti-TNF ilaçlarının idrar enfeksiyonlarının gelişimi üzerindeki etkilerini daha iyi ortaya çıkarmak için DMARD kullanan 29 RA ve 20 AS hastası çalışmaya dahil edildi.Bulgular: Anti-TNF tedavisine başlamadan önce aktif hastalığı olan ve anti-TNF tedavisine başlanan hastalar ile DMARD kullanan hastalar arasında üriner enfeksiyon gelişim sıklığı bakımından farklılıklara rağmen anlamlı bir fark yoktu. hastalık aktivitesinde. Anti-TNF ajanları ve DMARD kullanan AS hastaları idrar enfeksiyonlarının gelişim sıklığı açısından sağlıklı kontrol grubu ile karşılaştırıldığında; DMARD grubunda anlamlı bir fark bulunmazken, 2. ve 3. ziyaretlerde anti-TNF grubunda daha sık rastlandı. Anti-TNF tedavisinin, DMARD tedavisine kıyasla idrar yolu enfeksiyonlarının gelişme sıklığı için ek bir risk oluşturduğu tespit edildi.Sonuç: Anti-TNF tedavisi, RA ve AS hastalarında hastalık aktivitesini kontrol altında tutma konusunda oldukça etkili olsa da, enfeksiyon riskindeki artış nedeniyle daima dikkatli olmak gerekir.

Anahtar Kelimeler:

Ankilozan Spondilit, Anti-TNF, Romatoid Artrit

Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

Background: Our objective in this study is to investigate whether there is an increase in frequency of urinary infections in patients using anti-Tumor Necrosis Factor alpha (TNFα) compared to the patients using disease-modifying anti-rheumatic drugs (DMARD). Methods: 29 patients with rheumatoid arthritis (RA) and 20 patients with Ankylosing Spondylitis (AS), for whom anti-TNF agents were initiated for the first time, and 30 healthy controls were included in the study. Additionally, in order to reveal effects of anti-TNF medications on development of urinary infections better, 29 RA and 20 AS patients using DMARDs were also included in the study. Result: There was no significant difference in regard to frequency of development of urinary infections between patients with active disease before anti-TNF treatment for whom initiation of anti-TNF treatment was considered and the patients without active disease who were using DMARDs, despite of differences in disease activity. When the AS patients using anti-TNF agents and DMARDs were compared with the healthy control group in regard to frequency of development of urinary infections; while there was no significant difference in the DMARD group, it was more frequently encountered in the anti-TNF group at 2nd and 3rd visits. Anti-TNF treatment was determined to pose an additional risk for frequency of development of urinary infections compared to DMARD treatment. Conclusion: Although anti-TNF treatment is quite effective in taking disease activity under control in RA and AS patients, it is always necessary to be alert due to increased risk for infection.

Keywords:

Ankylosing Spondylitis, Anti-TNF, Rheumatoid Arthritis,

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