Predictors of infusion reactions during infliximab treatment in patients with arthritis
Predictors of infusion reactions during infliximab treatment in patients with arthritis
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DOI：
10.1186/ar2020
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发表时间：
2006-01-01
影响因子：
4.9
通讯作者：
Geborek, Pierre
中科院分区：
文献类型：
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作者：
Kapetanovic, Meliha C.;Larsson, Lotta;Geborek, Pierre
在本研究中，我们评估了基线抗核抗体（ANA）状态和使用甲氨蝶呤对类风湿关节炎（RA）或脊柱关节病（SpA）（包括银屑病关节炎）患者发生英夫利昔单抗相关输液反应的影响。所有患者与RA（n = 213）或SpA（n = 76）治疗英夫利西单抗在1999 - 2005年期间在瑞典隆德的风湿病科纳入。RA和SpA患者中ANA的检出率分别为28%和25%。由于基线特征的差异，我们使用二元逻辑回归模型计算比值比（OR），调整年龄，性别和泼尼松龙剂量。共有21%的RA患者和13%的SpA患者发生输液反应（P = 0.126）。仅基线ANA阳性的RA患者发生输液反应的OR为2.1。英夫利西单抗联合甲氨蝶呤和英夫利西单抗单药治疗的OR分别为3.1和3.6。合并英夫利西单抗（不含甲氨蝶呤）和ANA阳性，输注反应的OR为4.6。较低的发病年龄和较长的病程与输液反应相关（分别为P = 0.012和P = 0.036），但基线时的年龄、性别、C反应蛋白、红细胞沉降率、健康评估问卷和疾病活动性评分-28则无关。在SpA患者中未发现输液反应的预测因素。接受英夫利西单抗治疗但未接受甲氨蝶呤治疗的RA患者，基线时ANA阳性的患者发生英夫利西单抗相关输注反应的风险增加。
In the present study we evaluated the impact of baseline antinuclear antibody ( ANA) status and use of methotrexate on development of infliximab-related infusion reactions in patients with rheumatoid arthritis (RA) or spondylarthropathies (SpAs), including psoriatic arthritis. All patients with RA (n = 213) or SpA ( n = 76) treated with infliximab during the period 1999 2005 at the Department of Rheumatology in Lund, Sweden were included. ANAs were present in 28% and 25% of RA and SpA patients, respectively. Because of differences in baseline characteristics, we used a binary logistic regression model to calculate odds ratios (ORs), adjusting for age, sex and prednisolone dosage. Altogether 21% of patients with RA and 13% of patients with SpA developed infusion reactions ( P = 0.126). The OR for development of infusion reactions in RA patients with baseline ANA positivity alone was 2.1. Infliximab without methotrexate and infliximab as monotherapy were associated with ORs of 3.1 and 3.6, respectively. Combining infliximab without methotrexate and ANA positivity yielded an OR for infusion reaction of 4.6. Lower age at disease onset and longer disease duration were associated with infusion reactions ( P = 0.012 and P = 0.036, respectively), but age, sex, C-reactive protein, erythrocyte sedimentation rate, Health Assessment Questionnaire and Disease Activity Score-28 at baseline were not. No predictors of infusions reactions were identified in SpA patients. RA patients treated with infliximab without methotrexate, and who are positive at baseline for ANAs are at increased risk for developing infliximab-related infusion reactions.