OBJECTIVES: To investigate the occurrence and risk factors for infections in RA patients treated with tocilizumab. METHODS: A cohort of all RA patients (n = 112) starting tocilizumab therapy between October 2008 and March 2010 in Northern Bavaria was screened for infections. Mild/moderate and severe infections were recorded. Multivariate logistic regression analysis was used to define risk factors for infection. RESULTS: Overall, 26 patients developed infections [23.2%; 58.0/100 patient-years (py)], 18 of them were mild to moderate (16.1%, 40.1/100 py) and 8 were severe (17.9/100 py). Concomitant use of LEF and prednisone, high disease activity and previous therapy with rituximab were associated with the occurrence of mild/moderate infections. Severe infections were related to longer disease duration, exposure to more than three previous DMARDs and concomitant therapy with proton-pump inhibitors. CONCLUSION: The rate of infection in RA patients treated with tocilizumab in clinical practice is higher than in the clinical trial populations. Increased attention should especially be given to patients with longer disease duration, previous exposure to multiple DMARDs, i.e. previous exposure to rituximab and those receiving concomitant LEF, prednisone or proton-pump inhibitor treatment.
OBJECTIVES: To investigate the occurrence and risk factors for infections in RApatients treated with tocilizumab. METHODS: A cohort of all RApatients (n = 112) starting tocilizumab therapy between October 2008 and March 2010 in Northern Bavaria was screened for infections. Mild/moderate and severe infections were recorded. Multivariate logistic regression analysis was used to define risk factors for infection. RESULTS: Overall, 26 patients developed infections [23.2%; 58.0/100 patient-years (py)], 18 of them were mild to moderate (16.1%, 40.1/100 py) and 8 were severe (17.9/100 py). Concomitant use of LEF and prednisone, high disease activity and previous therapy with rituximab were associated with the occurrence of mild/moderate infections. Severe infections were related to longer disease duration, exposure to more than three previous DMARDs and concomitant therapy with proton-pump inhibitors. CONCLUSION: The rate of infection in RApatients treated with tocilizumab in clinical practice is higher than in the clinical trial populations. Increased attention should especially be given to patients with longer disease duration, previous exposure to multiple DMARDs, i.e. previous exposure to rituximab and those receiving concomitant LEF, prednisone or proton-pump inhibitor treatment.
Authors: Halie M Rando; Nils Wellhausen; Soumita Ghosh; Alexandra J Lee; Anna Ada Dattoli; Fengling Hu; James Brian Byrd; Diane N Rafizadeh; Ronan Lordan; Yanjun Qi; Yuchen Sun; Christian Brueffer; Jeffrey M Field; Marouen Ben Guebila; Nafisa M Jadavji; Ashwin N Skelly; Bharath Ramsundar; Jinhui Wang; Rishi Raj Goel; YoSon Park; Simina M Boca; Anthony Gitter; Casey S Greene Journal: mSystems Date: 2021-11-02 Impact factor: 6.496
Authors: Clark D Russell; Cameron J Fairfield; Thomas M Drake; Lance Turtle; R Andrew Seaton; Dan G Wootton; Louise Sigfrid; Ewen M Harrison; Annemarie B Docherty; Thushan I de Silva; Conor Egan; Riinu Pius; Hayley E Hardwick; Laura Merson; Michelle Girvan; Jake Dunning; Jonathan S Nguyen-Van-Tam; Peter J M Openshaw; J Kenneth Baillie; Malcolm G Semple; Antonia Ho Journal: Lancet Microbe Date: 2021-06-02
Authors: Josef S Smolen; Monika M Schoels; Norihiro Nishimoto; Ferdinand C Breedveld; Gerd R Burmester; Maxime Dougados; Paul Emery; Gianfranco Ferraccioli; Cem Gabay; Allan Gibofsky; Juan Jesus Gomez-Reino; Graeme Jones; Tore K Kvien; Miho Murakami; Neil Betteridge; Clifton O Bingham; Vivian Bykerk; Ernest H Choy; Bernard Combe; Maurizio Cutolo; Winfried Graninger; Angel Lanas; Emilio Martin-Mola; Carlomaurizio Montecucco; Mikkel Ostergaard; Karel Pavelka; Andrea Rubbert-Roth; Naveed Sattar; Marieke Scholte-Voshaar; Yoshiya Tanaka; Michael Trauner; Gabriele Valentini; Kevin L Winthrop; Maarten de Wit; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2012-11-21 Impact factor: 19.103