Risk of Severe Infection among Rheumatoid Arthritis Patients on Biological DMARDs: A Population-Based Cohort Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Abatacept | Tocilizumab | TNFi | Total | p-Value | |
---|---|---|---|---|---|
(N = 295) | (N = 142) | (N = 1343) | (N = 1780) | ||
Variable | |||||
Age, mean (SD) | 60.19 (13.62) | 52.84 (15.84) | 50.94 (17.58) | 52.63 (17.19) | <0.0001 |
Sex | |||||
Females | 246 (83.39) | 110 (77.46) | 937 (69.77) | 1293 (72.64) | <0.0001 |
Males | 49 (16.61) | 32 (22.54) | 406 (30.23) | 487 (27.36) | |
Drug use one year before cohort entry | |||||
csDMARDs | 246 (83.39) | 93 (65.49) | 1229 (91.51) | 1568 (88.09) | <0.0001 |
Corticosteroids | 244 (82.71) | 114 (80.28) | 967 (72.00) | 1325 (74.44) | 0.0002 |
Charlson comorbidity index | |||||
0 | 251 (85.08) | 113 (79.58) | 1276 (95.01) | 1640 (92.13) | <0.0001 |
≥1 | 44 (14.92) | 29 (20.42) | 67 (4.99) | 140 (7.78) | |
bDMARD at cohort entry | |||||
Abatacept | 295 (100.00) | - | - | 295 (16.57) | |
Etanercept | - | - | 572 (42.59) | 572 (32.13) | |
Infliximab | - | - | 66 (4.91) | 66 (3.71) | |
Adalimumab | - | - | 512 (38.12) | 512 (28.76) | |
Certolizumab pegol | - | - | 90 (6.70) | 90 (5.06) | |
Golimumab | - | - | 103 (7.67) | 103 (5.79) | |
Tocilizumab | - | 142 (100.00) | - | 142 (7.98) | |
Interstitial lung disease | |||||
No | 286 (96.95) | 133 (93.66) | 1327 (98.91) | 1746 (98.09) | <0.0001 |
Yes | 9 (3.05) | 9 (6.34) | 13 (1.19) | 34 (1.91) | |
Treatment interruptions | 146 | 80 | 724 | 950 | |
Number of events | 5 | 8 | 36 | 49 | |
Event type ^ | |||||
Pneumonia | 3 (60.00) | 4 (50.00) | 10 (27.78) | 17 (34.69) | 0.2605 * |
Meningitis/encephalitis | 0 (0.00) | 1 (12.50) | 2 (5.56) | 3 (6.12) | |
Bacteraemia/sepsis | 0 (0.00) | 0 (0.00) | 12 (33.33) | 12 (24.49) | |
Cellulitis/soft-tissue infections | 0 (0.00) | 1 (12.50) | 5 (13.89) | 6 (12.24) | |
Endocarditis | 0 (0.00) | 1 (12.50) | 1 (2.78) | 2 (4.08) | |
Pyelonephritis | 1 (20.00) | 1 (12.50) | 3 (8.33) | 5 (10.20) | |
Septic arthritis/osteomyelitis | 1 (20.00) | 0 (0.00) | 3 (8.33) | 4 (8.16) | |
Person years | 536.8 | 214.4 | 2823.47 | 3574.67 | |
Incidence Rate per 100 py | 0.93 | 3.73 | 1.28 | 1.37 |
Univariable Model | Mutivariable Model | |
---|---|---|
sHR (95% CI) | sHR (95% CI) | |
bDMARDs | ||
TNFi | 1 | 1 |
Abatacept | 0.731 (0.307–1.743) | 0.610 (0.247–1.508) |
Tocilizumab | 2.336 (1.207–4.521) | 2.493 (1.275–4.876) |
Age | 1.023 (1.000–1.047) | |
Sex (Females vs. Males) | 0.796 (0.413–1.534) | |
Corticosteroids | 3.490 (1.786–6.818) | |
Interstitial lung disease | 3.957 (1.196–13.096) | |
Charlson comorbidity index | 1.718 (1.334–2.211) |
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Bellan, M.; Scotti, L.; Ferrante, D.; Calzaducca, E.; Manfredi, G.F.; Sainaghi, P.P.; Barone-Adesi, F. Risk of Severe Infection among Rheumatoid Arthritis Patients on Biological DMARDs: A Population-Based Cohort Study. J. Clin. Med. 2022, 11, 2955. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11112955
Bellan M, Scotti L, Ferrante D, Calzaducca E, Manfredi GF, Sainaghi PP, Barone-Adesi F. Risk of Severe Infection among Rheumatoid Arthritis Patients on Biological DMARDs: A Population-Based Cohort Study. Journal of Clinical Medicine. 2022; 11(11):2955. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11112955
Chicago/Turabian StyleBellan, Mattia, Lorenza Scotti, Daniela Ferrante, Elisa Calzaducca, Giulia Francesca Manfredi, Pier Paolo Sainaghi, and Francesco Barone-Adesi. 2022. "Risk of Severe Infection among Rheumatoid Arthritis Patients on Biological DMARDs: A Population-Based Cohort Study" Journal of Clinical Medicine 11, no. 11: 2955. https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11112955