Category Archives: opportunistic infections

TB Hides In Bone Marrow

Michelle Fay Cortez writing in Bloomberg News reported on a study in “Science Translational Medicine.  Researchers said they have uncovered the first evidence of tuberculosis hiding in mesenchymal stem cells in the bone marrow of people treated for the disease.”

tb-bacteriaAccording to the article, “the bacteria’s hideout in the self-renewing cells, where they capitalize on protection from the body’s own immune system, may explain how the germs survive.”

This is disturbing news since these sequestered tuberculosis bacteria can be protected from drugs used to eradicate them.

This has important  implications for patients intending to go on biologic therapy for rheumatoid arthritis and other diseases.

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Anti-TNF Medications Lead To Higher Shingles Risk In RA Patients

One of the most painful and debilitating conditions is shingles.  Find out what a recent study showed…shingles

Nancy Walsh writing in MedPage Today reported, “Patients with rheumatoid arthritis (RA) undergoing treatment with agents such as Enbrel (etanercept), Remicade (infliximab) or Humira (adalimumab) appear to have a significantly increased risk for developing shingles,” according to a study published in the Annals of the Rheumatic Diseases. Researchers found that “the incidence of shingles among patients on anti-tumor necrosis factor (TNF) treatment was 1.6 per 100 patient-years, compared with an incidence of 0.8 per 100 patient-years among those receiving traditional disease-modifying anti-rheumatic drugs (DMARDs).”

Comment: What can I say?  These are worrisome findings and indicate that people with RA on biologics should be vaccinated.

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New rheumatoid arthritis drug… the inside scoop!

The first oral biologic drug has finally hit the runway.

Here’s the “skinny” on it from the American College of Rheumatology…

Xeljanz (tofacitinib) is a first-in-class oral JAK inhibitor which has shown clinical effectoveness in patients with moderate to severe rheumatoid arthritis. xeljanz

Tofacitinib is approved for patients with an inadequate response to both biologic and non-biologic disease-modifying anti-rheumatic drugs (DMARDS) .

It should not be used in combination with other biologic agents. Current labeling for tofacitinib does not include an indication for inhibition of structural damage.

Data on safety suggests that infections, including severe “traditional” infections, as well as opportunistic infections and Herpes zoster, have occurred. Long-term safety studies and post-marketing safety data is being collected. Monitoring for blood abnormalities, liver enzyme abnormalities, lipid abnormalities and kidney damage is appropriate prior to initiation of therapy and throughout treatment.

For more information on arthritis treatments and other arthritis problems,  go to:

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