Opportunistic infections in rheumatoid arthritis patients exposed to biologic therapy: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis.
Objectives. This analysis set out to estimate the risk of opportunistic infection (OI) among patients with RA by biologic class. Methods. The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis is a prospective observational cohort study established to evaluate safety of bio...
| Publicado en: | Rheumatology Vol. 57; no. 6; pp. 997 - 1002 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Jun2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=129787141&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 129787141 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14620324 DN9 jtl: Rheumatology issn: 14620324 maglogo: N pubinfo: dt: Jun2018 vid: 57 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 129787141 129787141 129787141 10.1093/rheumatology/key023 129787141 ppf: 997 ppct: 5 formats: tig: atl: Opportunistic infections in rheumatoid arthritis patients exposed to biologic therapy: results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis. aug: au: Rutherford, Andrew I Patarata, Eunice Subesinghe, Sujith Hyrich, Kimme L Galloway, James B affil: Academic Rheumatology Department, King's College London, London, UK Rheumatology Department, King's College Hospital NHS Foundation Trust, London, UK sug: subj: Arthritis, Rheumatoid Physiopathology Biological Products Infection Risk Factors Medical Organizations Human Arthritis, Rheumatoid Complications England Geographic Locations Prospective Studies Incidence After Care Pneumonia, Pneumocystis Risk Factors Rituximab Adverse Effects Opportunistic Infections Risk Factors Tuberculosis Diagnosis ab: Objectives. This analysis set out to estimate the risk of opportunistic infection (OI) among patients with RA by biologic class. Methods. The British Society for Rheumatology Biologics Register for Rheumatoid Arthritis is a prospective observational cohort study established to evaluate safety of biologic therapies. The population included adults commencing biologic therapy for RA. The primary outcome was any serious OI excluding tuberculosis (TB). Event rates were compared across biologic classes using Cox proportional hazards with adjustment for potential confounders identified a priori. Analysis of the incidence of TB was performed separately. Results. In total, 19 282 patients with 106 347 years of follow-up were studied; 142 non-TB OI were identified at a rate of 134 cases/100 000 patient years (pyrs). The overall incidence of OI was not significantly different between the different drug classes; however, the rate of Pneumocystis infection was significantly higher with rituximab than with anti-TNF therapy (adjusted hazard ratio = 3.2, 95% CI: 1.4, 7.5). The rate of TB fell dramatically over the study period (783 cases/100 000 pyrs in 2002 to 38 cases/ 100 000 pyrs in 2015). The incidence of TB was significantly lower among rituximab users than anti-TNF users, with 12 cases/100 000 pyrs compared with 65 cases/100 000 pyrs. Conclusions. The overall rate of OI was not significantly different between drug classes; however, a subtle difference in the pattern of OI was seen between the cohorts. Patient factors such as age, gender and comorbidity were the most important predictors of OI. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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