Risk of infection associated with Janus Kinase (JAK) inhibitors and biological therapies in inflammatory intestinal disease and rheumatoid arthritis. Prevention strategies

Gastroenterol Hepatol. 2021 Oct;44(8):587-598. doi: 10.1016/j.gastrohep.2021.01.007. Epub 2021 Feb 25.
[Article in English, Spanish]

Abstract

Patients with certain immune-mediated inflammatory diseases, such as rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), have an increased risk of severe infectious diseases than the general population, which are mainly associated with the immunosuppressive treatments that they receive. These treatments act on the immune system through different mechanisms, causing different degrees of immunosuppression and a variable risk depending on whether the pathogen is a virus, bacteria or fungus. This article reviews the most relevant literature on the subject, which was selected and discussed by a panel of experts. The aim of this article is to review the risk of infections in patients with IBD and RA, and the potential preventive measures.

Keywords: Anti-TNF; Artritis reumatoide; Biologics; Biológicos; Enfermedad inflamatoria intestinal; Immunosuppression; Infecciones; Infections; Inflammatory bowel disease; Inhibidores del JAK; Inmunosupresión; JAK inhibitors; Rheumatoid arthritis; Tofacitinib; Vaccines; Vacunas.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid / immunology
  • Arthritis, Rheumatoid / therapy*
  • Bacterial Infections / prevention & control*
  • Biological Therapy / adverse effects*
  • COVID-19 / etiology
  • Hepatitis A / prevention & control
  • Hepatitis B / prevention & control
  • Herpes Zoster / prevention & control
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Inflammatory Bowel Diseases / immunology
  • Inflammatory Bowel Diseases / therapy*
  • Influenza, Human / prevention & control
  • Janus Kinase Inhibitors / adverse effects*
  • Pneumococcal Infections / prevention & control
  • Risk Factors
  • Tuberculosis, Pulmonary / prevention & control
  • Vaccination Coverage
  • Vaccines, Inactivated / administration & dosage
  • Virus Diseases / prevention & control*

Substances

  • Immunosuppressive Agents
  • Janus Kinase Inhibitors
  • Vaccines, Inactivated