" Serious skin & soft tissue infections in rheumatoid arthritis patients taking anti-tumor necrosis factor alpha drugs: A nested case-control study"

Ngoc J. Wasson, Cara D. Varley, Pascale Schwab, Rongwei (Rochelle) Fu, Kevin Winthrop

Research output: Contribution to journalArticle

7 Scopus citations


Background: Anti-tumor necrosis factor alpha (anti-TNF) drugs are very effective for the treatment of rheumatoid arthritis but may increase the risk of serious bacterial infections. We assessed the association between the risk of serious skin and soft tissue infections (SSSTI) and the use of these agents in rheumatoid arthritis patients (RA).Methods: We conducted a nested case-control study among rheumatoid arthritis patients in the Veterans Integrated Service Network 20 from 2000-2008. We identified rheumatoid arthritis patients with SSSTI, matched them to three sets of RA controls and used conditional logistic regression to compare the risk of SSSTI between patients treated and those not treated with an anti-TNF drug, after adjusting for known confounders and important covariates. Limited by the design, we could not assess (absolute) risk but only relative risk in terms of association.Results: Among the 97 cases and 291 controls, 90 percent were male, 62 percent white, with a mean age of 63 years. Twenty percent received anti-TNF drugs during the study period. Thirty-nine percent of cases and 15 percent of controls died, (OR 3.5, 95% CI: 2.033, 6.11, p

Original languageEnglish (US)
Article number533
JournalBMC Infectious Diseases
Issue number1
Publication statusPublished - Nov 11 2013



  • Anti-TNF therapy
  • Arthritis
  • Infectious skin diseases
  • Rheumatoid
  • Tumor necrosis factor-alpha

ASJC Scopus subject areas

  • Infectious Diseases

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