OBJECTIVE: The use of TNF inhibitors leads to an increased risk of serious infections in RA. Predicting this risk would facilitate the prevention of serious infections. The objective of this study was to identify which factors are predictive of the increased risk of serious infections in RA patients treated with TNF inhibiting therapy. METHODS: Data from the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry of 2044 patients with RA were used for the analyses. Data were censored at stopping TNF inhibitors or end of observation time up to 5 years. Univariate and multivariate analysis of baseline variables was performed using Cox regression with time to the first serious infection as dependent variable. RESULTS: During a follow-up time of 5 years, 128 of 2044 (6.3%) patients developed a first serious infection with a total of 141 serious infections. The incidence rate in the first year after start of TNF inhibiting therapy was 4.57 first serious infections per 100 patient-years and 2.91 per 100 patient-years over 5 years. Age, corticosteroid use, visual analogue scale (VAS) pain, HAQ, tender joint count 28 joints (TJC28) and the presence of comorbidities were significant predictors for developing a serious infection during TNF inhibiting therapy in the multivariate model. CONCLUSION: Age, corticosteroid use, VAS pain, HAQ, TJC28 and the presence of comorbidities all at baseline were significant predictors for developing a serious infection during TNF inhibiting therapy in RA patients.
OBJECTIVE: The use of TNF inhibitors leads to an increased risk of serious infections in RA. Predicting this risk would facilitate the prevention of serious infections. The objective of this study was to identify which factors are predictive of the increased risk of serious infections in RApatients treated with TNF inhibiting therapy. METHODS: Data from the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry of 2044 patients with RA were used for the analyses. Data were censored at stopping TNF inhibitors or end of observation time up to 5 years. Univariate and multivariate analysis of baseline variables was performed using Cox regression with time to the first serious infection as dependent variable. RESULTS: During a follow-up time of 5 years, 128 of 2044 (6.3%) patients developed a first serious infection with a total of 141 serious infections. The incidence rate in the first year after start of TNF inhibiting therapy was 4.57 first serious infections per 100 patient-years and 2.91 per 100 patient-years over 5 years. Age, corticosteroid use, visual analogue scale (VAS) pain, HAQ, tender joint count 28 joints (TJC28) and the presence of comorbidities were significant predictors for developing a serious infection during TNF inhibiting therapy in the multivariate model. CONCLUSION: Age, corticosteroid use, VAS pain, HAQ, TJC28 and the presence of comorbidities all at baseline were significant predictors for developing a serious infection during TNF inhibiting therapy in RApatients.
Authors: Roberto Ranza; Maria Celina de la Vega; Ieda Maria Magalhães Laurindo; Marìa Gimena Gómez; David Cezar Titton; Adriana Maria Kakehasi; Alejandro Brigante; Alejandro Benitez; Aline Ranzolin; Amelia Granel; Ana María Cappuccio; Ana Quinteros; André Luiz Shinji Hayata; Andrea Smichowski; Ângela Luzia Branco P Duarte; Barbara Stadler Kahlow; Carolina Sánchez Andia; Claiton Viegas Brenol; Edson Velozo; Eduardo Mussano; Enrique R Soriano; Georges Basile Christopoulos; Geraldo da Rocha Castelar Pinheiro; Gláucio Ricardo Werner de Castro; Gustavo Casado; Hellen Mary da Silveira Carvalho; Ida Elena Exeni; Inês Guimarães da Silveira; Ingrid Petkovic; Ivanio Alves Pereira; Izaias Pereira da Costa; Javier Eduardo Rosa; José Roberto Silva Miranda; Julio Cesar Bertacini de Moraes; Manoel Barros Bertolo; Manuel Buhl; Maria Alícia Lázaro; Maria de Fátima Lobato C da Sauma; Marcelo de Medeiros Pinheiro; Monica Díaz; Mônica Valéria Siqueira Santana de Vechi; Osvaldo Luis Cerda; Pablo Astesana; Pablo Finucci Curi; Paulo Louzada-Jr; Reginaldo Botelho Teodoro; Roberto Acayaba Toledo; Sílvia Papasidero; Valeria Valim; Vander Fernandes; Veronica Saurit; Washington Alves Bianchi; Rogério de Melo Costa Pinto; Miguel Angel Descalzo; Juan Jesus Gomez-Reino Journal: Clin Rheumatol Date: 2019-04-17 Impact factor: 2.980
Authors: Ninad S Chaudhary; John P Donnelly; Justin X Moore; John W Baddley; Monika M Safford; Henry E Wang Journal: Crit Care Date: 2017-07-13 Impact factor: 9.097
Authors: Jeffrey R Curtis; Kevin Winthrop; Cathy O'Brien; Matladi N Ndlovu; Marc de Longueville; Boulos Haraoui Journal: Arthritis Res Ther Date: 2017-12-15 Impact factor: 5.156