Methotrexate and newer RA treatments can also increase infection risk, so there’s often a tradeoff between treatment efficacy and infection risk, he said. Vaccination remains an important risk reduction strategy, and sometimes discontinuing or changing the immunosuppressive treatment proves necessary. The use of Janus kinase inhibitors, such as tofacitinib, adds another layer of complication for the rheumatologist; the reactivation of latent viruses in this scenario is a concern.
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“The take-home message is that, yes, these drugs all increase the risk of infections at about the same rate, but they also reduce prednisone use,” Dr. Winthrop added.
Larry Beresford is a freelance medical journalist in Oakland, Calif.
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