Physicians split on infection risk of immunomodulatory medications

Findings published in the <i>Journal of Clinical Rheumatology</i> indicate that experienced physicians have a wide range of opinions on the infection risks of anti-tumor necrosis factor (anti-TNF) medications.

Findings published in the Journal of Clinical Rheumatology indicate that experienced physicians have a wide range of opinions on the infection risks of anti-tumor necrosis factor (anti-TNF) medications. Researchers distributed a survey to more than 600 health care providers at the Philadelphia-based Hospital of the University of Pennsylvania. Physicians in various departments rated 15 commonly used therapies on a scale of 0–100 based on immunosuppressant risk if hypothetically taken for 1 year. Among experienced physicians, 95% viewed dapsone as low risk, while 93% regarded hydroxychloroquine as low risk. In contrast, less experienced providers viewed both as medium- or high-risk treatments. Experienced physicians were also more likely than less experienced providers to consider prednisone doses of 10–20 mg as medium- or high-risk. Among less experienced physicians, 55% said anti-TNF treatments carried a high risk for infection. Experienced providers, meanwhile, split their responses about anti-TNF therapies across low-, medium-, and high-risk, the authors found. Rebecca Sharim, MD, and colleagues wrote: "Future studies are needed to clarify the risk of infection with various immunomodulatory agents and summarize risks in a way that is easily accessible to physicians across medical specialties."