Incidence and Risk Factors for Invasive Fungal Infections in Patients Initiating Tumor Necrosis Factor-Alpha Inhibitors for Inflammatory Bowel Disease and Rheumatoid Arthritis

Clin Infect Dis. 2025 Feb 24;80(2):364-366. doi: 10.1093/cid/ciae444.

Abstract

In a commercial claims database analysis, <0.5% of patients with inflammatory bowel disease or rheumatoid arthritis developed an invasive fungal infection (IFI) within 1 year of initiating tumor necrosis factor-alpha therapy. Histoplasmosis was the most common IFI type. Overall IFI incidence varied based on region, underlying conditions, and use of certain immunosuppressive medications.

Keywords: TNF-α inhibitors; histoplasmosis; inflammatory bowel disease; invasive fungal infections; rheumatoid arthritis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / drug therapy
  • Female
  • Humans
  • Incidence
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / drug therapy
  • Invasive Fungal Infections* / epidemiology
  • Male
  • Middle Aged
  • Risk Factors
  • Tumor Necrosis Factor-alpha* / antagonists & inhibitors
  • Young Adult

Substances

  • Tumor Necrosis Factor-alpha