Article Text

Download PDFPDF
Serious infections with antirheumatic therapy: are biologicals worse?
  1. K L Winthrop
  1. Correspondence to:
    K L Winthrop
    Division of Infectious Diseases, School of Medicine, Oregon Health Sciences University, 3375 SW Terwilliger Boulevard, Portland, OR 97239-4197, USA; winthrop{at}


This paper reviews the current evidence for the role of antirheumatic therapy in the development of serious infections in patients with rheumatoid arthritis (RA). Prednisone is clearly associated with increased infectious risk, but no definitive data link methotrexate to infection. Emerging data suggest that biological agents also pose increase infectious risk, particularly when used in combination with corticosteroids or methotrexate. Further research is needed in this important aspect of RA treatment. In the meantime, the author recommends that physicians should remain vigilant for serious infections in their patients with RA and use appropriate vaccines and screening procedures to mitigate their risk.

  • infection
  • biological agents
  • antirheumatic therapy
  • rheumatoid arthritis

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: none declared