Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010.
Frequency of Hospitalized Infections Is Reduced in Rheumatoid Arthritis Patients Who Received Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs after 2010.
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DOI：
10.1155/2018/6259010
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发表时间：
2018
影响因子：
4.1
通讯作者：
Kawakami A
中科院分区：
文献类型：
--
作者：
Ichinose K;Shimizu T;Umeda M;Fukui S;Nishino A;Koga T;Kawashiri SY;Iwamoto N;Tamai M;Nakamura H;Sato S;Origuchi T;Kawakami A
生物疾病缓解抗风湿药物 (bDMARD) 和靶向合成 (ts) DMARD 在类风湿关节炎 (RA) 治疗中非常重要。 RA 患者中与 bDMARD/tsDMARD 相关的住院感染风险尚不清楚。 我们回顾性分析了 2003 年 7 月至 2015 年 1 月在长崎大学医院接受 bDMARD/tsDMARD 治疗的 275 名 RA 患者，共 449 次治疗。我们确定了患者在 3 年观察期内需要住院治疗的感染发生率和危险因素。 35 名（12.7%）患者经历过住院感染。几种 bDMARD/tsDMARD 之间的住院感染风险没有显着差异。多变量分析显示，慢性肺病的合并症（调整后的 HR 5.342，95% CI 2.409-12.42，p < 0.0001）和 2010 年之前开始 bDMARD/tsDMARD（调整后的 HR 4.266，95% CI 1.827-10.60，p = 0.0007）具有显着性住院感染的独立危险因素。与2010年之前组相比，2010年或之后开始治疗的患者组在开始bDMARD/tsDMARD治疗时的患者年龄较高，并且使用抗结核药物预防的比例较高，而2010年之后组的疾病活动度和接受>5mg泼尼松龙治疗的患者数量较低。 这是2010年后首次报告患者接受bDMARD或tsDMARD治疗后，住院感染频率显着下降。我们的结果表明，更新的诊断和治疗标准的公布可能有助于降低住院感染风险，并更好地了解风湿病学家使用bDMARD/tsDMARD。
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. 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. 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. 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.
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影响因子：
2.3
作者：
Hashimoto A;Suto S;Horie K;Fukuda H;Nogi S;Iwata K;Tsuno H;Ogihara H;Kawakami M;Komiya A;Furukawa H;Matsui T;Tohma S
通讯作者：
Tohma S
影响因子：
2.5
作者：
Kato, Eri;Sawada, Tetsuji;Tohma, Shigeto
通讯作者：
Tohma, Shigeto
影响因子：
2.1
作者：
Berglin, E.;Dahlqvist, S. R.
通讯作者：
Dahlqvist, S. R.
影响因子：
5.9
作者：
Michaud, Tzeyu L.;Rho, Young Hee;Choi, Hyon K.
通讯作者：
Choi, Hyon K.
影响因子：
14.2
作者：
Vidal, S;de la Horra, C;Calder贸n, EJ
通讯作者：
Calder贸n, EJ