Risk of serious infections in arthritis patients treated with biological drugs: a matched cohort study and development of prediction model
| Autor: | Mikkel Østergaard, Simon Krabbe, Bente Glintborg, Mette Nørgaard, Kathrine Lederballe Grøn, Merete Lund Hetland, Frank Mehnert, Dorte Ejg Jarbøl |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Arthritis Antirheumatic Agents/therapeutic use Logistic regression Severity of Illness Index Arthritis Rheumatoid Cohort Studies Epidemiology Medicine Pharmacology (medical) education.field_of_study Framingham Risk Score Hazard ratio Spondylarthropathies/drug therapy Infections/epidemiology Middle Aged Hospitalization biologicals Antibodies Monoclonal Humanized/therapeutic use Arthritis Rheumatoid/drug therapy Antirheumatic Agents Area Under Curve epidemiology Female Ustekinumab Biological Products/therapeutic use Rituximab Adult medicine.medical_specialty Population Arthritis Psoriatic/drug therapy Antibodies Monoclonal Humanized Infections Rheumatology Internal medicine Tumor Necrosis Factor Inhibitors/therapeutic use Clinical Decision Rules Rituximab/therapeutic use Humans education Aged Proportional Hazards Models Biological Products Receiver operating characteristic Proportional hazards model business.industry Arthritis Psoriatic medicine.disease Ustekinumab/therapeutic use infection Logistic Models ROC Curve Case-Control Studies Spondylarthropathies Tumor Necrosis Factor Inhibitors business |
| Zdroj: | Krabbe, S, Grøn, K L, Glintborg, B, Nørgaard, M, Mehnert, F, Jarbøl, D E, Østergaard, M & Hetland, M L 2021, ' Risk of serious infections in arthritis patients treated with biological drugs : a matched cohort study and development of prediction model ', Rheumatology (Oxford, England), vol. 60, no. 8, pp. 3834-3844 . https://doi.org/10.1093/rheumatology/keaa876 Krabbe, S, Grøn, K L, Glintborg, B, Nørgaard, M, Mehnert, F, Jarbøl, D E, Østergaard, M & Hetland, M L 2021, ' Risk of serious infections in arthritis patients treated with biological drugs : a matched cohort study and development of prediction model ', Rheumatology, vol. 60, no. 8, pp. 3834-3844 . https://doi.org/10.1093/rheumatology/keaa876 |
| ISSN: | 1462-0332 |
| DOI: | 10.1093/rheumatology/keaa876 |
| Popis: | Objectives Serious infection is a concern for patients with inflammatory joint diseases treated with biological drugs (bDMARDs). The objectives were to compare risk of serious infection, defined as infection leading to hospitalization, in patients initiating bDMARD treatment with the general population and, second, to develop a simple clinical prediction model and to obtain risk estimates for individual patients. Methods Matched-cohort study based on nationwide registries in Denmark. Patients with rheumatoid arthritis, axial spondyloarthritis and psoriatic arthritis initiating first bDMARD monitored in the DANBIO registry were matched 1:10 by age, gender and postal code with controls from the general population. The risk of serious infection during 12 months’ follow-up was assessed with Cox regression. Prediction models were developed using logistic regression and compared using area under the ROC curve (AUC). Results We included 11 372 patients and 113 715 controls. During follow-up, 522 patients (4.6%) and 1,434 controls (1.3%) developed a serious infection (hazard ratio 3.7, 95% confidence interval: 3.4–4.1). Age-stratified risk was largely similar across diagnoses. A simple prediction model, the “DANBIO infection risk score” based on age and a count of six clinical risk factors had moderate discriminative power (internal validation: AUC 0.69), which was comparable to that of the existing RABBIT risk score (external validation: AUC 0.68). Conclusion Patients with inflammatory joint diseases initiating bDMARD treatment had four times increased risk of serious infection compared with the general population. A simple prediction model, feasible for shared decision-making, was developed to obtain risk estimates for individual patients. |
| Databáze: | OpenAIRE |
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