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Background: Immunomodulating biological agents increase the risk of fungal infections in patients with chronic inflammatory rheumatism, however, they have been more frequently described in rheumatoid arthritis. Objectives: To determine the incidence of fungal infections in patients with spondyloarthritis on biotherapy in the Moroccan registry of biotherapy (RBSMR) at 3-year follow-up and to identify factors associated with the risk of infection in these patients. Methods: This was a prospective study, with a three-year follow-up, which included 194 spondyloarthritis patients treated with biologics. Patients' sociodemographic clinical and paraclinical data were collected. The type of biotherapy used and episodes of fungal infections before and during treatment were reported. Any resulting changes in treatment were reported. Also reported were the frequency of use of corticosteroids and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), disease activity, and various comorbidities before and at the time of fungal infection during the 3 years of follow-up. Regarding fungal infection, the germ and location were specified. Results: The mean age of patients was 43.23±13.68 years, with a male predominance (63.4%). Seven spondyloarthritis patients out of 194 (3.6%) had a fungal infection, including 4 men and 3 women. The mean age was 44±17.23 years, with a mean disease duration of evolution of 11 years. All 7 patients had comorbidities before and during the fungal infection. At the time of the fungal infection, only 1 patient was on corticosteroids, and no use of CsDMARDS (Conventional synthetic Disease-Modifying Antirheumatic Drugs) was noted at the time of infection. Six patients were on TNF alpha inhibitors at the time of infection (5 ADALIMUMAB, 1 ETANERCEPT), and 1 patient on SECUKINUMAB. In terms of treatment, a transient discontinuation of biologics was recommended, but no switch was observed in any of the 7 patients. Patients were active both before and after the infection. No cases of systemic fungal infection were noted. In the 8 cases of fungal infections, there were 7 cases of phanereal involvement, including one with TRICHOPHYTON RUBRUM and 1 case of vaginal candidiasis. Conclusion: The incidence of fungal infections in patients with spondyloarthritis is low, and remains similar to data in the literature. It seems to be related to disease activity and type of biologics. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
Bourjila et al. (Sat,) studied this question.