Should Immunosuppression Be Interrupted During an Infection?

In a randomized trial, withholding immunosuppression in patients with auto-inflammatory diseases did not lower the likelihood of progression to serious infection.

Clinicians often stop immunosuppressive drugs during their patients' infections, but data are sparse to guide this practice. To determine the safety and efficacy of interrupting immunosuppression, researchers randomized 1142 patients with inflammatory rheumatic diseases to either continuation or interruption of immunosuppression upon development of an infection of at least moderate severity (requiring minimal or noninvasive intervention). Most patients were receiving conventional disease-modifying rheumatic agents (e.g., azathioprine, methotrexate).

A total of 474 patients developed clinically significant infections, and the likelihood of progression to life-threatening or severe infection (requiring hospitalization or otherwise limiting abi…

Reviewing Author

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Daniel Kaul, MD

Disclosures

Grant/Research SupportNobelpharma; Pfizer

Leadership Positions in Professional SocietiesAmerican Society of Transplantation (Program Committee)

Should Immunosuppression Be Interrupted During an Infection?

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Reviewing Author