Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010
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 case...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Journal of Immunology Research |
| Online Access: | http://dx.doi.org/10.1155/2018/6259010 |
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| author | Kunihiro Ichinose Toshimasa Shimizu Masataka Umeda Shoichi Fukui Ayako Nishino Tomohiro Koga Shin-ya Kawashiri Naoki Iwamoto Mami Tamai Hideki Nakamura Shuntaro Sato Tomoki Origuchi Atsushi Kawakami |
| author_facet | Kunihiro Ichinose Toshimasa Shimizu Masataka Umeda Shoichi Fukui Ayako Nishino Tomohiro Koga Shin-ya Kawashiri Naoki Iwamoto Mami Tamai Hideki Nakamura Shuntaro Sato Tomoki Origuchi Atsushi Kawakami |
| author_sort | Kunihiro Ichinose |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-60e8a018f6c04ff2855df43eec633ab1 |
| institution | OA Journals |
| issn | 2314-8861 2314-7156 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Immunology Research |
| spelling | doaj-art-60e8a018f6c04ff2855df43eec633ab12025-08-20T02:35:18ZengWileyJournal of Immunology Research2314-88612314-71562018-01-01201810.1155/2018/62590106259010Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010Kunihiro Ichinose0Toshimasa Shimizu1Masataka Umeda2Shoichi Fukui3Ayako Nishino4Tomohiro Koga5Shin-ya Kawashiri6Naoki Iwamoto7Mami Tamai8Hideki Nakamura9Shuntaro Sato10Tomoki Origuchi11Atsushi Kawakami12Department of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanClinical Research Center, Nagasaki University Hospital, Nagasaki, JapanRehabilitation Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanDepartment of Immunology and Rheumatology, Unit of Advanced Preventive Medical Sciences Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, JapanBackground. 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.http://dx.doi.org/10.1155/2018/6259010 |
| spellingShingle | Kunihiro Ichinose Toshimasa Shimizu Masataka Umeda Shoichi Fukui Ayako Nishino Tomohiro Koga Shin-ya Kawashiri Naoki Iwamoto Mami Tamai Hideki Nakamura Shuntaro Sato Tomoki Origuchi Atsushi Kawakami Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010 Journal of Immunology Research |
| title | Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010 |
| title_full | Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010 |
| title_fullStr | Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010 |
| title_full_unstemmed | Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010 |
| title_short | Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010 |
| title_sort | frequency of hospitalized infections is reduced in rheumatoid arthritis patients who received biological and targeted synthetic disease modifying antirheumatic drugs after 2010 |
| url | http://dx.doi.org/10.1155/2018/6259010 |
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