According to a story from mdmag.com, the publication recently conducted an interview with Dr. Eric Ruderman. Eric is a professor at Northwestern University with the Division of Rheumatology. The magazine decided to talk with Eric about disease modifying anti-rheumatic drugs (DMARDs). These treatments have been valuable for treating severe inflammatory disorders such as rheumatoid arthritis and ankylosing spondylitis. However, they can also cause severe side effects and other complications. In this interview, the doctor discusses how physicians take into account these potential risks when treating patients.
Infections, Infections, Infections
Eric emphasizes that the biggest risk with this class of medication is infection. Treating autoimmune, inflammatory diseases often means interfering with the activity of the immune system and suppressing its activity. This can provide significant symptom relief for patients, but the patient may also be less likely to fight off an infection. However, the risk of infection is not nearly as high as doctors initially thought, and overall the benefit of DMARDs far outweighs the risks that they present for infection.
Accounting for Other Health Issues
When deciding whether to prescribe drugs of this type, caregivers need to take into account the risk of side effects and complications. As a result, DMARDs may not necessarily be the best option for everyone. Some patients may already have other health characteristics that could potentially compound the risk of infections. Such patients could include those who are older, patients with cardiovascular issues, or patients with diabetes.
What Disease is Being Treated?
The risk of infection can also vary depending on the type of disease being treated and its overall severity. Patients with diseases that are more likely to have systemic effects would be at greater vulnerability to infection. A patient with rheumatoid arthritis, which often has serious systemic impacts, would be at greater risk than most patients with ankylosing spondylitis or psoriasis.
Another factor to consider with DMARDs is that the risk of infection greatest during the first 6 to 12 months that patient begins treatment.
Taking Precautions
There are several precautions that doctors can take to keep patients safe while using these drugs. One useful step is screening patients for latent infections that could become more dangerous if the immune system is suppressed. Another consideration is other treatments that a patient could be using. As an example, it is probably not a good idea to be using DMARDs and a steroid like prednisone at the same time, because both of these drugs can increase infection risk.
