Serious Infections

In rheumatoid arthritis patients in whom there is more long-term data, it appears that etanercept may increase the risk of serious infection. In clinical trials, the rates of infection that required hospitalization or parental antibiotic therapy were 0.04 per patient-year in etaner-cept treated groups, which is very similar to the total population. In post marketing data on the use of eta-nercept, serious infections and sepsis were reported in patients using etanercept, but most of these cases were in patients receiving concomitant immunosuppressive therapies. Great care should be practiced when placing a patient on multiple immunosuppressive therapies, and they should be monitored closely. Rare cases of reactivation of tuberculosis have been noted in patients receiving etanercept, and consideration should be given to performing a purified protein derivative (PPD) skin test prior to initiation of treatment, especially if geographic location makes a patient more at risk.

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