Assessment of Infections in Autoimmune Rheumatic Patients Treated With Disease Modifying Antirheumatic Drugs

Abstract

Background: Autoimmune rheumatic diseases (ARDs) are chronic inflammatory disorders that often require long-term treatment with disease-modifying antirheumatic drugs (DMARDs) to control disease activity and prevent organ damage. However, due to their immunosuppressive effects, DMARDs may increase patients’ susceptibility to various infections.

Objective: To assess various types of infections occurring among patients of autoimmune rheumatic diseases receiving disease-modifying antirheumatic drugs in the Department of Rheumatology at Pakistan Institute of Medical Sciences (PIMS), Islamabad

Methods: A cross-sectional study was conducted in Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad during April to October 2023. Data of 150 patients having autoimmune rheumatic diseases who were receiving disease modifying antirheumatic drugs was collected after taking informed consent and ethical approval. Frequency of various infections in patients with autoimmune rheumatic diseases on disease-modifying antirheumatic drug therapy was observed. Data was analyzed in Statistical Package for Social Sciences version 23.0.

Results: The mean age was 40.7±17.1 years and most of study patients were females 129 (86.0%). All patients experienced infection. Of total, 60 (40.0%) had lower respiratory tract infections, and 45 (30.0%) had skin/soft tissue infections. Other frequent infections were upper respiratory tract infections 24 (16.0%), gastrointestinal tract infections 14 (9.3%) and sepsis found in 7 (4.6%) of study cases. None of the patients had pneumococcal or influenza vaccination.

Conclusion: An absolute infection rate was found among ARDs patients under DMARDs therapy. This is alarming situation and underscores the need for risk stratification and preventive measures before initiation of therapies.