Dinny Wallis1, Arane Thavaneswaran1, Nigil Haroon1, Renise Ayearst1, Robert D Inman2. 1. Division of Rheumatology, Toronto Western Hospital, University of Toronto, Ontario, Canada. 2. Division of Rheumatology, Toronto Western Hospital, University of Toronto, Ontario, Canada. robert.inman@uhnresearch.ca.
Abstract
OBJECTIVES: Long-term data on infection risk in axial SpA (axSpA) are sparse. TNF inhibitors (TNFis) are increasingly being used in axSpA, with infection being the most important adverse event. We aimed to investigate the frequency of infections in axSpA and to identify factors predisposing to infection. METHODS: Data were extracted from a longitudinal observational cohort of patients with axSpA. Infection rates were calculated and multivariate analysis was performed to investigate the association of independent variables with infection. RESULTS: Data were analysed for 440 patients followed for a total of 1712 patient-years (pys). A total of 259 infections, of which 23 were serious, were recorded in 185 patients. The overall rate of any infection was 15 (95% CI 13, 17)/100 pys and the serious infection rate was 1.3 (95% CI 0.9, 2.0)/100 pys. There was no significant difference in the rate of any infection or serious infection in patients on TNFis compared with patients never on biologic agents. In the multivariate analysis, DMARD treatment, but not TNFi treatment, was associated with risk of infection. Age, disease duration, smoking status, BASFI, BASDAI, co-morbidity score and hospitalization were not associated with an increased risk of infection. CONCLUSION: The serious infection rate in axSpA in this observational cohort is low when compared with rates reported in other rheumatic diseases. Biologic use was not a significant risk factor for serious infection.
OBJECTIVES: Long-term data on infection risk in axial SpA (axSpA) are sparse. TNF inhibitors (TNFis) are increasingly being used in axSpA, with infection being the most important adverse event. We aimed to investigate the frequency of infections in axSpA and to identify factors predisposing to infection. METHODS: Data were extracted from a longitudinal observational cohort of patients with axSpA. Infection rates were calculated and multivariate analysis was performed to investigate the association of independent variables with infection. RESULTS: Data were analysed for 440 patients followed for a total of 1712 patient-years (pys). A total of 259 infections, of which 23 were serious, were recorded in 185 patients. The overall rate of any infection was 15 (95% CI 13, 17)/100 pys and the serious infection rate was 1.3 (95% CI 0.9, 2.0)/100 pys. There was no significant difference in the rate of any infection or serious infection in patients on TNFis compared with patients never on biologic agents. In the multivariate analysis, DMARD treatment, but not TNFi treatment, was associated with risk of infection. Age, disease duration, smoking status, BASFI, BASDAI, co-morbidity score and hospitalization were not associated with an increased risk of infection. CONCLUSION: The serious infection rate in axSpA in this observational cohort is low when compared with rates reported in other rheumatic diseases. Biologic use was not a significant risk factor for serious infection.
Authors: Ho Yin Chung; Lai Shan Tam; Shirley Chiu Wai Chan; Jason Pui Yin Cheung; Pui Yan Wong; Chu Oi Ciang; Hoi Yan Ng; Mei Yan Law; Tin Lok Lai; Ching Han Wong Journal: Ther Adv Musculoskelet Dis Date: 2020-10-13 Impact factor: 5.346
Authors: Alexandre Sepriano; Andrea Regel; Désirée van der Heijde; Jürgen Braun; Xenofon Baraliakos; Robert Landewé; Filip Van den Bosch; Louise Falzon; Sofia Ramiro Journal: RMD Open Date: 2017-01-27
Authors: Mariana Cecconi; Roberto Ranza; David C Titton; Júlio C B Moraes; Manoel Bertolo; Washington Bianchi; Claiton Brenol; Hellen M Carvalho; Glaucio R W de Castro; Izaias P Costa; Maria F L Cunha; Ângela Duarte; Vander Fernandes; Marlene Freire; Paulo Louzada-Junior; José C Macieira; José R S Miranda; Ivanio A Pereira; Geraldo R C Pinheiro; Barbara Stadler; Roberto A Toledo; Valeria Valim; Miguel A Descalzo; Rogerio M C Pinto; Ieda Laurindo Journal: J Clin Rheumatol Date: 2020-03 Impact factor: 3.517