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Early Lyme borreliosis in patients treated with tumour necrosis factor-alfa inhibitors
ID
Maraspin-Čarman, Vera
(
Author
),
ID
Bogovič, Petra
(
Author
),
ID
Rojko, Tereza
(
Author
),
ID
Ogrinc, Katarina
(
Author
),
ID
Ružić-Sabljić, Eva
(
Author
),
ID
Strle, Franc
(
Author
)
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MD5: DDDF58D65E7A9EE21D7D101F33ABFA47
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https://www.mdpi.com/2077-0383/8/11/1857
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Abstract
The study evaluated the course and outcome of erythema migrans in patients receiving tumour necrosis factor-alpha (TNF-α) inhibitors. Among 4157 adults diagnosed with erythema migrans in the period 2009–2018, 16 (2.6%) patients were receiving TNF-α inhibitors (adalimumab, infliximab, etarnecept, golimumab), often in combination with other immunosuppressants, for rheumatic (13 patients) or inflammatory bowel (three patients) disease. Findings in this group were compared with those in 32 sex- and age-matched immunocompetent patients diagnosed with erythema migrans in the same years. In comparison with the control group, the immunocompromised patients had a shorter incubation period (7 vs. 14 days; p = 0.0153), smaller diameter of erythema migrans (10.5 vs. 15.5 cm; p = 0.0014), and more frequent comorbidities other than immune-mediated diseases (62.5% vs. 25%, p = 0.0269), symptoms/signs of disseminated Lyme borreliosis (18.8% vs. 0%, p = 0.0324), and treatment failure (25% vs. 0%, p = 0.0094). After retreatment with an antibiotic, the clinical course of Lyme borreliosis resolved. Continuing TNF inhibitor treatment during concomitant borrelial infection while using identical approaches for antibiotic treatment as in immunocompetent patients resulted in more frequent failure of erythema migrans treatment in patients receiving TNF inhibitors. However, the majority of treatment failures were mild, and the course and outcome of Lyme borreliosis after retreatment with antibiotics was favourable.
Language:
English
Keywords:
Lyme borreliosis
,
immunocompromised host
,
TNF-α inhibitors
,
erythema migrans
,
treatment
,
outcome
Work type:
Article
Typology:
1.01 - Original Scientific Article
Organization:
MF - Faculty of Medicine
Publication status:
Published
Publication version:
Version of Record
Year:
2019
Number of pages:
13 str.
Numbering:
Vol. 8, iss. 11, art. 1857
PID:
20.500.12556/RUL-133139
UDC:
616.9
ISSN on article:
2077-0383
DOI:
10.3390/jcm8111857
COBISS.SI-ID:
6634412
Publication date in RUL:
12.11.2021
Views:
857
Downloads:
144
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Record is a part of a journal
Title:
Journal of clinical medicine
Shortened title:
J. clin. med.
Publisher:
MDPI
ISSN:
2077-0383
COBISS.SI-ID:
5405759
Licences
License:
CC BY 4.0, Creative Commons Attribution 4.0 International
Link:
http://creativecommons.org/licenses/by/4.0/
Description:
This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:
02.11.2019
Projects
Funder:
ARRS - Slovenian Research Agency
Project number:
P3-0296
Name:
Bolezni in povzročitelji, ki jih v Sloveniji prenašajo členonožci
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