Friday, 15 Dec 2017

You are here

Infliximab Does Not Increase Perioperative Infection

Staying on a TNF inhibitor (TNFi) throughout major surgery has generatlly been associated with higher rates of perioperative infection (https://buff.ly/2iBFVjp).  On the other hand, discontinuation of the TNFi prior to surgery is associated with lower rates of  infection (https://buff.ly/2iAFZQf)

George and colleagues analyzed the timing of inflixiamb discontinuation before elective arthroplasty and found that infliximab given within 4 weeks of elective knee or hip arthroplasty was not associated with a higher risk of short  or long-term serious infection. 

Infection risk was primarily associated with glucocorticoid use, especially >10 mg/day. The 30-day infection risk was double for short term infection (OR 2.11; 95% CI 1.30–3.40) and long term prosthetic infections (HR 2.70; 95% CI 1.30–5.60). Other risk factors for infection included elderly age, comorbidities, revision surgery, and previous hospitalized infection.

They examined infliximab patients hospitalized for infection (within 30 days) and found an event rate of 6.3% (270 out of 4,288 surgeries) They then compared infliximab use - those stopping infliximab <4 weeks of surgery and compared this cohort to those stopping infliximab versus longer 8–12 weeks.  The overall infection rate did not differ between groups and the long term prosthetic infection rates were also similar between group (2.9 per 100 person-years).

 

 

Add new comment

More Like This

Why TNF Inhibitors May Work in Some Autoinflammatory Patients

The NLRP3 inflammasome is a critical component of the innate immune system and activation of NLRP3 inflammasome results in caspase-1–dependent secretion of the proinflammatory cytokines IL-1β and IL-18. Gain-of-function missense mutations in NLRP3 is thought to drive many of the autoinflammatory diseases, especially the cryopyrin-associated periodic syndromes (CAPS).

CALM Study: Tight Control with Anti-TNF Wins in Crohn's Disease

Not unlike rheumatoid arthritis and other inflammatory disorders, therapeutic efficacy in Crohn's disease (CD) is often assessed clinically. There is growing use and interest in biomarkers of intestinal inflammation, such as faecal calprotectin and C-reactive protein. But Lancet has now reported a clinical trial has shown that a tight control strategy can yield better responses to TNF inhibitors when compared to usual care. 

Amgen-Abbvie Settle Humira Biosimilar Patent Dispute

Amgen's biosimilar version of adalimumab (Humira) was FDA-approved in September 2016 and given the trade name Amjevita (generic: adalimumab-atto). This new TNF inhibitor biosimilar has not yet been to market because of legal wranglings over patent issues by Abbvie's Humira.

Another Adalimumab Biosimilar Approved

On Friday August 25th, the FDA approved another adalimumab biosimilar: Cyltezo (generic name: adalimumab-adbm).

Adalimumab Biosimilars Adding Up

Reuters reports that yet another adalimumab biosimilar has been approved by European Union regulators.

The new drug is named Imraldi, and is manufactured by Samsung Bioepis, a company who has several biosimilars approved or in development for worldwide use.