Frequency of severe infections in rheumatic disease patients receiving bDMARDs post-kidney transplantation: a multicenter study

Yıldırım T. D., Kökoğlu E. O., COŞKUN B. N., Yıldırım D., Basaran E., ŞENEL A. S., ...Daha Fazla

Clinical Rheumatology, cilt.44, sa.2, ss.831-838, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 44 Sayı: 2
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s10067-024-07287-7
  • Dergi Adı: Clinical Rheumatology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Veterinary Science Database
  • Sayfa Sayıları: ss.831-838
  • Anahtar Kelimeler: Biologic disease-modifying anti-rheumatic drugs (bDMARDs), Kidney transplantation, Rheumatic diseases, Severe infection
  • Eskişehir Osmangazi Üniversitesi Adresli: Hayır

Özet

Objectives: To evaluate the incidence and characteristics of severe infections in rheumatic patients receiving biologic disease-modifying anti-rheumatic drugs (bDMARDs) after kidney transplantation. Methods: This multicenter, retrospective study included 38 patients who had undergone kidney transplantation and received bDMARDs for rheumatic diseases. Demographic, clinical, and treatment data were collected. Severe infections were defined as those requiring hospitalization, and the incidence of severe infections was calculated per 100 patient years. Risk factors for severe infections were analyzed. Results: Of the 38 patients (median age 40.5 years), 52.6% experienced severe infections, with a total of 39 severe infection episodes. The incidence of severe infections was 26.2 per 100 patient-years. The most common infections were urinary tract infections (43.5%) and pneumonia (30.8%). Familial Mediterranean Fever (FMF) was the most common rheumatic disease (57.9%), and the median disease duration was 18.5 years. Most patients (68.4%) were using IL-1 inhibitors, and 31.6% were on anti-TNF therapy. There was no significant difference between patients with and without infections in terms of gender, pre-transplant biological therapy use, or type of biological therapy used. Four patients (11%) died from infection-related complications, including coronavirus disease-19 (COVID-19). Conclusion: Rheumatic patients receiving bDMARDs post-kidney transplantation have a high risk of severe infections. The concurrent use of immunosuppressive therapy and bDMARDs may further increase this risk, necessitating close infection monitoring and management.