Predictive risk factors of serious infections in patients with rheumatoid arthritis treated with abatacept in common practice: results from the Orencia and Rheumatoid Arthritis (ORA) registry

Autor: Elisabeth Solau-Gervais, Bernard Combe, Elodie Perrodeau, S. Rist, O. Meyer, J.-E. Gottenberg, Gabriel Baron, Isabelle Pane, Xavier Mariette, Philippe Ravaud, T. Schaeverbeke, Jean Sibilia, J.H. Salmon, X. Le Loët, Damien Loeuille, Christian Marcelli, Thomas Bardin, R.M. Flipo, Eric Houvenagel, Maxime Dougados, Alain Cantagrel, Philippe Gaudin
Přispěvatelé: Service de Rhumatologie [Reims], Centre Hospitalier Universitaire de Reims (CHU Reims), Institut de biologie moléculaire et cellulaire (IBMC), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service de rhumatologie[Lille], Hôpital Roger Salengro-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de rhumatologie, CHU Bordeaux [Bordeaux], Hôpital Saint Philibert [Lomme], Groupe Hospitalier de l'Institut Catholique de Lille (GHICL), Service de Rhumatologie [CHU de Grenoble], Hôpital Sud de Grenoble, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional d'Orléans (CHR), Physiopathologie des arthrites, Université Louis Pasteur - Strasbourg I, Service de rhumatologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut de Recherche sur la Fusion par confinement Magnétique (IRFM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Service de rhumatologie [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de Rhumatologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Mobilités : Vieillissement, Pathologie, Santé (COMETE), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie [CHU Lariboisière], Hôpital Lariboisière, Régulation de la réponse immune, infection VIH-1 et autoimmunité, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Roger Salengro [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional d'Orléans (CHRO), Service de rhumatologie [CHU Rouen], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Université catholique de Lille (UCL)-Université catholique de Lille (UCL), Groupe de recherche sur les maladies systémiques (EA 4058), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5), Physiopathologie et biothérapies des maladies inflammatoires et autoimmunes, Université de Rouen Normandie (UNIROUEN), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Multivariate analysis
Immunology
Comorbidity
Opportunistic Infections
General Biochemistry
Genetics and Molecular Biology
Abatacept
Arthritis
Rheumatoid
03 medical and health sciences
Immunocompromised Host
0302 clinical medicine
Rheumatology
Risk Factors
Internal medicine
Diabetes mellitus
medicine
Immunology and Allergy
Humans
[SDV.BBM]Life Sciences [q-bio]/Biochemistry
Molecular Biology
030212 general & internal medicine
Registries
Aged
030203 arthritis & rheumatology
Univariate analysis
business.industry
Age Factors
Middle Aged
medicine.disease
Connective tissue disease
3. Good health
Surgery
Clinical trial
Rheumatoid arthritis
Antirheumatic Agents
Female
France
business
Immunosuppressive Agents
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
medicine.drug
Zdroj: Annals of the Rheumatic Diseases
Annals of the Rheumatic Diseases, BMJ Publishing Group, 2016, 75 (6), pp.1108-1113. ⟨10.1136/annrheumdis-2015-207362⟩
Annals of the Rheumatic Diseases, 2016, 75 (6), pp.1108-1113. ⟨10.1136/annrheumdis-2015-207362⟩
ISSN: 0003-4967
1468-2060
DOI: 10.1136/annrheumdis-2015-207362⟩
Popis: ObjectivesLittle data are available regarding the rate and predicting factors of serious infections in patients with rheumatoid arthritis (RA) treated with abatacept (ABA) in daily practice. We therefore addressed this issue using real-life data from the Orencia and Rheumatoid Arthritis (ORA) registry.MethodsORA is an independent 5-year prospective registry promoted by the French Society of Rheumatology that includes patients with RA treated with ABA. At baseline, 3 months, 6 months and every 6 months or at disease relapse, during 5 years, standardised information is prospectively collected by trained clinical nurses. A serious infection was defined as an infection occurring during treatment with ABA or during the 3 months following withdrawal of ABA without any initiation of a new biologic and requiring hospitalisation and/or intravenous antibiotics and/or resulting in death.ResultsBaseline characteristics and comorbidities: among the 976 patients included with a follow-up of at least 3 months (total follow-up of 1903 patient-years), 78 serious infections occurred in 69 patients (4.1/100 patient-years). Predicting factors of serious infections: on univariate analysis, an older age, history of previous serious or recurrent infections, diabetes and a lower number of previous anti-tumour necrosis factor were associated with a higher risk of serious infections. On multivariate analysis, only age (HR per 10-year increase 1.44, 95% CI 1.17 to 1.76, p=0.001) and history of previous serious or recurrent infections (HR 1.94, 95% CI 1.18 to 3.20, p=0.009) were significantly associated with a higher risk of serious infections.ConclusionsIn common practice, patients treated with ABA had more comorbidities than in clinical trials and serious infections were slightly more frequently observed. In the ORA registry, predictive risk factors of serious infections include age and history of serious infections.
Databáze: OpenAIRE
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