Effect of Use of Anti-TNF Medications on Development of Urinary Infections in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis

Background: Our objective in this study is to investigate whether there is an increase in frequency of urinary infections in patients using anti-Tumor Necrosis Factor alpha (TNFα) compared to the patients using disease-modifying anti-rheumatic drugs (DMARD). Methods: 29 patients with rheumatoid arthritis (RA) and 20 patients with Ankylosing Spondylitis (AS), for whom anti-TNF agents were initiated for the first time, and 30 healthy controls were included in the study. Additionally, in order to reveal effects of anti-TNF medications on development of urinary infections better, 29 RA and 20 AS patients using DMARDs were also included in the study. Result: There was no significant difference in regard to frequency of development of urinary infections between patients with active disease before anti-TNF treatment for whom initiation of anti-TNF treatment was considered and the patients without active disease who were using DMARDs, despite of differences in disease activity. When the AS patients using anti-TNF agents and DMARDs were compared with the healthy control group in regard to frequency of development of urinary infections; while there was no significant difference in the DMARD group, it was more frequently encountered in the anti-TNF group at 2nd and 3rd visits. Anti-TNF treatment was determined to pose an additional risk for frequency of development of urinary infections compared to DMARD treatment. Conclusion: Although anti-TNF treatment is quite effective in taking disease activity under control in RA and AS patients, it is always necessary to be alert due to increased risk for infection