Incidence and risk factors for invasive fungal infections in patients initiating TNF-alpha inhibitors for inflammatory bowel disease and rheumatoid arthritis

Ian Hennessee; Kaitlin Benedict; Nathan C Bahr; Shari R Lipner; Jeremy A W Gold

doi:10.1093/cid/ciae444

Incidence and risk factors for invasive fungal infections in patients initiating TNF-alpha inhibitors for inflammatory bowel disease and rheumatoid arthritis

Clin Infect Dis. 2024 Sep 3:ciae444. doi: 10.1093/cid/ciae444. Online ahead of print.

Authors

Ian Hennessee^{1

2}, Kaitlin Benedict¹, Nathan C Bahr³, Shari R Lipner⁴, Jeremy A W Gold¹

Affiliations

¹ Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
² Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
³ Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
⁴ Department of Dermatology, Weill Cornell Medicine, New York, New York, USA.

PMID: 39223720
DOI: 10.1093/cid/ciae444

Abstract

In a commercial claims database analysis, <0.5% of patients with inflammatory bowel disease or rheumatoid arthritis developed an IFI within one year of initiating TNF-alpha therapy. Histoplasmosis was the most common IFI type. Overall IFI incidence varied based on region, underlying conditions, and use of certain immunosuppressive medications.

Keywords: TNF-alpha inhibitors; biologics; candidiasis; coccidioidomycosis; histoplasmosis; immunosuppressive medications; inflammatory bowel disease; invasive fungal infections; rheumatoid arthritis; underlying medical conditions.

Published by Oxford University Press on behalf of Infectious Diseases Society of America 2024.