RESEARCH - ACR: Prednisone Risks Significant for Pneumonia in RA Patients

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ACR: Prednisone Risks Significant for Pneumonia in Rheumatoid Arthritis

Patients

By Bruce Sylvester

SAN ANTONIO, TX -- October 22, 2004 -- Rheumatoid arthritis patients being

treated with prednisone have a significantly higher risk of developing

pneumonia than patients using biologic medications, researchers reported

here on October 20th at the 68th Annual Scientific Meeting of the American

College of Rheumatology.

" While it is good news that the increased rate of pneumonia in people taking

biologics is relatively low, the risk of pneumonia associated with

prednisone use is substantial, " said investigator Frederick Wolfe, MD,

director, National Data Bank for Rheumatic Diseases, Wichita, Kansas. " This

means that rather than being a relatively benign therapy, prednisone appears

to be a significant contributor to the risks associated with development of

pneumonia in the treatment of rheumatoid arthritis. "

Dr. Wolfe and colleagues undertook a 2 and a half year study that compared

the risks of biologic therapy and prednisone use in 15,966 patients with

long-term arthritis and an average age of 60.5 years. The investigators

evaluated patient responses to semi-annual questionnaires that were also

validated by analysis of medical and death records.

Results show that 53.0% used a biologic agent, 18.7% used

hydroxychloroquine, 55.7% used methotrexate, 32.4% used a disease-modifying

antirheumatic agent (DMARD) without a tumor necrosis factor agent, 10.2%

used neither a DMARD nor a biologic agent, and 38.4 % used prednisone with

or without other agents.

Dr. Wolfe reported that subjects who used biologic drugs were 30% more

likely to get pneumonia, and subjects who used prednisone were 170% more

likely to get pneumonia compared to subjects who used other treatments.

An estimated 35% to 45% of patients treated for rheumatoid arthritis

currently use prednisone, and more than 70% of patients will use it at some

point, Dr. Wolfe said.

Functional status and disease severity was somewhat predictive of infection,

but the study results suggest that steroid therapy could play a larger

detrimental role than previously known, he noted.

" These data indicate an increased risk among biologic users, but also

demonstrate a much larger risk from corticosteroids, and suggest more

attention should be paid to this commonly used but less safe therapy, he

concluded.

[Presentation title: Rates and Predictors of Pneumonia in Patients With

Rheumatoid Arthritis: Strong Association With Corticosteroid Therapy.

Abstract 1763]

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org