Comparing the burdens of opportunistic infections among patients with systemic rheumatic diseases: a nationally representative cohort study
Autor: | Chun Yu Lin, Jiun-Ling Wang, Tsai-Ching Hsu, Chi Hua Ko, Chung-Yuan Hsu |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty lcsh:Diseases of the musculoskeletal system Opportunistic infection Taiwan Systemic rheumatic disease Opportunistic Infections Polymyositis Dermatomyositis Cohort Studies 03 medical and health sciences Systemic lupus erythematosus 0302 clinical medicine Cost of Illness Rheumatic Diseases Internal medicine parasitic diseases Humans Medicine 030212 general & internal medicine Aged Retrospective Studies 030203 arthritis & rheumatology business.industry Proportional hazards model Hazard ratio Middle Aged medicine.disease Rheumatology Rheumatoid arthritis Female lcsh:RC925-935 business Research Article Follow-Up Studies Cohort study |
Zdroj: | Arthritis Research & Therapy Arthritis Research & Therapy, Vol 21, Iss 1, Pp 1-10 (2019) |
ISSN: | 1478-6362 |
Popis: | Objective To estimate and compare the burdens of opportunistic infections and herpes zoster in real-world practice among patients with various systemic rheumatic diseases. Methods This 13-year cohort study used national health insurance data to compare the incidence rates (IRs) of nine opportunistic infections among patients with five rheumatic diseases. The analyses were stratified according to follow-up duration using Poisson regression, and Cox models were used to compare the risk of first opportunistic infection. Results During 2000–2013, we identified 76,966 patients who had polymyositis/dermatomyositis (PM/DM, 2270 cases), systemic lupus erythematosus (SLE, 15,961 cases), systemic sclerosis (SSc, 2071 cases), rheumatoid arthritis (RA, 38,355 cases), or primary Sjögren’s syndrome (pSS, 18,309 cases). The IR of opportunistic infections was highest for PM/DM cases (61.3/1000 person-years, 95% confidence interval [CI] 56.6–66.2), followed by SLE cases (43.1/1000 person-years, 95% CI 41.7–44.5), SSc cases (31.6/1000 person-years, 95% CI 28.3–35.1), RA cases (25.0/1000 person-years, 95% CI 24.4–25.7), and pSS cases (24.1/1000 person-years, 95% CI 23.1–25.2). Multivariable Cox analysis revealed that, relative to SLE, PM/DM was associated with a significantly higher risk of opportunistic infections (hazard ratio 1.18, 95% CI 1.08–1.29). The risk of opportunistic infections was highest during the first year after the diagnosis of all five rheumatic diseases. Conclusions The risk of opportunistic infection was highest for PM/DM, followed by SLE, SSc, RA, and pSS. Careful observation and preventive therapy for opportunistic infections may be warranted in selected PM/DM patients, especially during the first year after the diagnosis. |
Databáze: | OpenAIRE |
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