The comparative risk of serious infections among rheumatoid arthritis patients starting or switching biological agents
The comparative risk of serious infections among rheumatoid arthritis patients starting or switching biological agents
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DOI：
10.1136/ard.2010.146365
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发表时间：
2011-08-01
影响因子：
27.4
通讯作者：
Delzell, Elizabeth
中科院分区：
文献类型：
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作者：
Curtis, Jeffrey R.;Xie, Fenglong;Delzell, Elizabeth
背景目前尚不清楚抗肿瘤坏死因子α和具有不同作用机制的生物制剂是否具有相似的安全性。本研究评估了类风湿性关节炎（RA）患者开始或转换各种生物制剂的住院感染的发病率。方法使用2005年1月至2009年8月美国一家大型医疗保健组织的数据库，作者确定了RA登记者及其治疗事件，按前一年没有使用生物制剂（“无生物制剂”）或从不同生物制剂转换（“转换者”）分层。结局是使用先前验证的算法确定的住院感染。比例风险模型估计住院感染的风险比，比较每种生物制剂与infliximab.Results在7847生物治疗事件，63%是生物免费的患者和37%的转换。有364例住院感染。无生物制剂患者和转换者的住院感染率分别为4.6和7.0/100人年（p
Background It is unclear whether anti-tumour necrosis factor alpha and biological agents with different mechanisms of action have similar safety. This study evaluated the incidence of hospitalised infections among rheumatoid arthritis (RA) patients starting or switching various biological agents.Methods Using a database from a large US healthcareorganisation from January 2005 to August 2009, the authors identified enrollees with RA and their treatment episodes entailing the new use of a biological agent, stratified by no biological use in the previous year ('biological-free') or switching from a different biological agent ('switchers'). Outcomes were hospitalised infections identified using previously validated algorithms. Proportional hazards models estimated the hazard ratio of hospitalised infections, comparing each biological agent with infliximab.Results Among 7847 biological treatment episodes, 63% were for biological-free patients and 37% for switchers. There were 364 hospitalised infections. Rates of hospitalised infection among biologicalfree patients and switchers were 4.6 and 7.0 per 100 person-years, respectively (p