LAUSR

Background Anti Tumor Necrosis Factor alpha (TNFα) has significantly improved the prognosis of some chronic inflammatory diseases (CID). Nevertheless, they carry with them a significant risk of opportunistic infections, imposing a rigorous surveillance and an adequate education of the patients. In a context of endemic tuberculosis, it is imperative to take the appropriate precautions to detect this kind of infection in rheumatisers under anti TNFα. Objectives The aim of our work was to study the profile of infectious incidents in patients treated with anti TNFα. Methods This is a prospective and descriptive study in patients treated with anti-TNFα over a 12-year period (2006- 2018). We examined all infectious complications for each patient who received an anti-TNFα for with CID while assessing the level of severity, the type of infection and the risk factors that may be related to this type of incident. Results During the study period, 134 patients were identified, these patients were followed for ankylosing spondylitis (AS) for 58 cases, 36 for enteric rheumatism, 23 for psoriatic arthritis and 17 for rheumatoid arthritis. The mean age was 46.3 years (19-64 years), the mean age of the disease was 44.2 months (8-140). The molecules used were: infliximab, etanercept, adalimumab with a respective number n (%) = 29 (21), 44 (33), 61 (46). Of the 134 patients evaluated, 71 were diagnosed and treated by a physician (in 47 patients), only 5 were serious: 2 cases of tuberculosis were reported (intestinal and ganglionic tuberculosis), 1 case of chickenpox of the adult, 1 case with perianal abscess, 1 case of erysipelas of the lower limb. The infection was bacterial, viral or mycotic [n (%) = 38 (53), 61 (86), 7 (8)]. A large proportion of the patients were on conventional immunosuppressive therapy. The factors related to the occurrence of infectious incidents were: use of corticosteroids p <0.0001,habitat in rural areas p= 0,042. Conclusion More than a third of patients have infectious complications after TNFα treatment in our study sometimes with serious issue. Thus, with the emergence of these accidents, the physician has to be very vigilant when instituting this biotherapy, and secondly, a rigorous and prolonged monitoring of the patients. Disclosure of Interests None declared