Pharmacology · single question
A patient with Rheumatoid Arthritis — what could be a complication of their treatment?
Show answer and explanation
Correct answer: A. Infection (immunosuppression)
Infection (A). RA treatment typically involves immunosuppressive medications:
• Methotrexate (DMARD): suppresses folate metabolism → immunosuppression → increased infection risk.
• Biologics (TNF-α inhibitors: adalimumab, etanercept, infliximab): suppress TNF → major risk of serious bacterial, fungal, and opportunistic infections (including TB reactivation!).
• Corticosteroids: broad immunosuppression → increased infection susceptibility.
• Dental significance of RA treatment:
- Screen for TB before starting biologics
- Higher susceptibility to oral infections (candidiasis, herpes, periodontal infections)
- Methotrexate can cause oral ulcers (mucositis)
- NSAIDs (used in RA) → GI bleeding, impaired platelet function.
• RA itself is associated with increased CV risk and TMJ involvement.
• Methotrexate (DMARD): suppresses folate metabolism → immunosuppression → increased infection risk.
• Biologics (TNF-α inhibitors: adalimumab, etanercept, infliximab): suppress TNF → major risk of serious bacterial, fungal, and opportunistic infections (including TB reactivation!).
• Corticosteroids: broad immunosuppression → increased infection susceptibility.
• Dental significance of RA treatment:
- Screen for TB before starting biologics
- Higher susceptibility to oral infections (candidiasis, herpes, periodontal infections)
- Methotrexate can cause oral ulcers (mucositis)
- NSAIDs (used in RA) → GI bleeding, impaired platelet function.
• RA itself is associated with increased CV risk and TMJ involvement.