A recent study on the severity of acute respiratory viral adverse events related to antirheumatic disease therapies found that some therapies, such as glucocorticoid medications and inhibitors of tumor necrosis factor (TNF), a substance in the body that causes inflammation, may be associated with increased respiratory viral events while others don’t show increased frequency.
The paper was published in Seminars in Arthritis and Rheumatism and co-authored by Adam Kilian, MD, assistant professor of medicine at the George Washington University School of Medicine and Health Sciences (SMHS), and Sonia Silinsky Krupnikova, MD, a rheumatology fellow at SMHS.
Kilian, who serves as a regional leader for the COVID-19 Global Rheumatology Alliance, and the paper’s other authors reviewed 180 studies on acute respiratory viral adverse events, or AEs, related to antirheumatic disease therapies. They noted that COVID-19, a respiratory viral infection, may put people who take immunosuppressive medications at higher risk of adverse outcomes from the virus, as was the case with studied respiratory viral AEs.
The researchers looked at studies on therapies including acute anti-inflammatory drugs, conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and targeted synthetic DMARDs, among others.
They found that glucocorticoids were associated with a higher frequency of acute upper and lower respiratory viral events, and the same held true for some csDMARDS. Mild viral respiratory infections occurred more frequently in studies in which patients were treated with janus kinase inhibitors, TNF inhibitor drugs, and agents targeting interleukin-17, a pro-inflammatory cytokine.
The review revealed gaps in knowledge and understanding of antirheumatic disease therapies’ impact on acute respiratory viral infections. The authors hope the review can encourage research aimed at identifying subpopulations of patients at greater risk for or from acute viral infections.
“Reporting viral respiratory AEs in future study designs would be of interest to rheumatology patients and practitioners in understanding the risks of medications,” the authors conclude. “In addition, with increase widespread viral PCR testing in the COVID-19 pandemic, immediate research opportunities exist to clarify the safety of antirheumatic therapies in terms of viral respiratory complications.”
Read the full paper, titled “Acute respiratory viral adverse events during use of antirheumatic disease therapies”
