Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010

• Ichinose, Kunihiro

• Shimizu, Toshimasa

• Umeda, Masataka

• Fukui, Shoichi

• Nishino, Ayako

• Koga, Tomohiro

• Kawashiri, Shin-ya

• Iwamoto, Naoki

• Tamai, Mami

• Nakamura, Hideki

• Sato, Shuntaro

• Origuchi, Tomoki

• Kawakami, Atsushi

Abstract

Background: Biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic (ts) DMARDs are important in rheumatoid arthritis (RA) treatment. The risk of hospitalized infection associated with bDMARDs/tsDMARDs in RA patients is unclear. Methods: We retrospectively analyzed the cases of the 275 RA patients with 449 treatment episodes who were administered a bDMARD/tsDMARD at Nagasaki University Hospital in July 2003-January 2015. We determined the incidence and risk factors of infection requiring hospitalization in the patients during a 3-year observation period. Results: Thirty-five (12.7%) of the patients experienced a hospitalized infection. The hospitalized infection risk did not differ significantly among several bDMARDs/tsDMARDs. A multivariate analysis revealed that the comorbidities of chronic lung disease (adjusted HR 5.342, 95% CI 2.409-12.42, p < 0.0001) and the initiation of bDMARDs/tsDMARDs before 2010 (adjusted HR 4.266, 95% CI 1.827-10.60, p = 0.0007) are significant independent risk factors for hospitalized infection. Compared to the before-2010 group, the group of patients whose treatment initiated in 2010 or later showed higher patient ages at the initiation of bDMARD/tsDMARD treatment and a higher rate of the use of prophylaxis with an antituberculosis agent, whereas the disease activities and number of the patients who received >5?mg of prednisolone were lower in the after-2010 group. Conclusions: This is the first report that the frequency of hospitalized infection significantly decreased when the patients were treated with a bDMARD or tsDMARD after 2010. Our results indicate that the updated announcement of diagnosis and treatment criteria might contribute to a reduced risk of hospitalized infection and a better understanding of the use of bDMARDs/tsDMARDs by rheumatologists.

Journal of immunology research, 2018, 6259010; 2018

Journal

• Journal of Immunology Research

  Journal of Immunology Research 2018 6259010-, 2018

  Hindawi

Keywords

• Immunology
• General Medicine
• Immunology and Allergy

Details

• CRID: 1050005822275627392
• NII Article ID: 120006987897
• ISSN: 23148861
• ISSN: 23147156
• DOI: 10.1155/2018/6259010
• HANDLE: 10069/38711
• Web Site: https://nagasaki-u.repo.nii.ac.jp/records/1447
• Web Site: http://downloads.hindawi.com/journals/jir/2018/6259010.pdf
• Web Site: http://downloads.hindawi.com/journals/jir/2018/6259010.xml
• Text Lang: en
• Article Type: journal article
• Data Source:
  • IRDB
  • Crossref
  • CiNii Articles
  • KAKEN