Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose
Biological drug therapy is frequently used to treat autoimmune diseases.
These drugs have an increased risk of infections, among them opportunistic infections.
To evaluate the frequency and type of opportunistic infections in patients with auto immune rheumatic diseases treated with biologic drugs compared to controls
Establish whether disease and treatment features influence frequency and severity of opportunistic infections
Methods
Biobadasar is database of rheumatic diseases patients treated with biologic drugs in Argentina. Created in 2010, it includes patients with a diagnosis according to accepted criteria treated with biologic drug therapy and controls not treated with biologic drugs.
Opportunistic infections (OI) are caused by pathogens (bacteria, viruses, fungi, parasites or protozoa), that usually do not cause disease in a healthy person (WHO)
The purpose of this work is to study the characteristics of opportunistic infections in patients with rheumatic diseases on biologic drug therapy compared with controls using the BIOBADAR database
Statistical analysis was done using Chi-square test and t test with a significant p ≤ 0.05.
Results
We included 2356 patients, 1275 54% on biologic drug therapy and 1081, 46% controls; 1862/2356, 79% were women, mean age 53.83 (SD6.02) years. Rheumatoid arthritis was the most common diagnosis 1829/2356, 77.6%.
Opportunistic infections were diagnosed in 40/1275 3.1% of patients treated with biologics, while 11/1081,1% of controls (p = 0.0004, OR 3.1, 95% CI 1.6-6.1).
Herpes Zoster was observed in 37 patients followed 6 Candidiasis, 2 Histoplasmosis, and one patient for each of the following, Cytomegalovirus, Pneumocystis jirovecii, hominis Blastocystis, Cryptosporidium, Echinococcus and Proteus.
Hospital admission was needed for 6 / 51, 11.7% of patients .
The median number of months from disease onset to the OI was 127 (IQR 46-223) months and from biological treatment onset to OI was 9 (IQR 4-18.5) months.
Table 1: Demographic Characteristics, Pathology and Treatment According to the Presence of Opportunistic Infections in Patients Treated with Biologics N: 1275
|
|
With Opportunistic Infection (N:40) |
Without Opportunistic Infection (N: 1235) |
p |
OR (IC95%) |
|
Female n (%) |
33 (82.5) |
969 (72.5) |
0.69 |
0.77 (0.33-1.76) |
|
Years m±DS |
59.5 ± 14 |
53 ± 16 |
0.02 |
|
|
Month history M (RIQ) |
60 (49-69) |
56 (44-65) |
0.07 |
|
|
Neoplasia n (%) |
4 (10) |
16 (1.3) |
0.003 |
8.46 (2.69-26.59) |
|
Lymphoma n (%) |
0 |
2 (0.2) |
1 |
0.96 (0.95-0.97) |
|
ischemic heart disease n (%) |
1 (2.5) |
18 (1.5) |
0.45 |
1.73 (0.22-13.31) |
|
Diabetes n (%) |
3 (7.5) |
78 (6.3) |
0.73 |
1.2 (0.36-3.98) |
|
kidney failure n (%) |
3 (7.5) |
12 (1.0) |
0.01 |
8.26 (2.23-30.5) |
|
Heart Failure n (%) |
1 (2.5) |
18 (1.5) |
0.45 |
1.73 (0.22-13.31) |
|
EPOC n (%) |
0 |
26 (2.1) |
1 |
0.96 (0.95-0.97) |
|
Corticosteroids n (%) |
28 (70) |
622 (51.0) |
0.02 |
2.24 (1.12-4.44) |
|
Methotrexate n (%) |
17 (42.5) |
892 (73.1) |
0.00009 |
0.27 (0.14-0.51) |
|
Leflunomide n (%) |
10 (25) |
253 (20.7) |
0.51 |
1.27 (0.61-2.64) |
|
Sulfasalazine n (%) |
1 (2.5) |
96 (7.9) |
0.36 |
0.30 (0.04-2.21) |
|
Azathioprine n (%) |
2 (5.0) |
13 (1.1) |
0.79 |
4.89 (1.06-22.43) |
Conclusion
Opportunistic infections were more frequent in patients treated with biological drugs than in controls.
The most common opportunistic infection was Herpes zoster.
A history of cancer and renal failure, and concomitant treatment with corticosteroids were associated with of opportunistic infections.
Methotrexate therapy was not associated with OI.
Disclosure:
L. Encinas,
None;
M. Haye Salinas,
None;
V. Saurit,
None;
A. J. Alvarellos,
None;
F. Caeiro,
None;
C. Battagliotti,
None;
I. E. Exeni,
None;
C. Gobbi,
None;
B. Pons-Estel,
None;
I. Strusberg,
None;
S. Paira,
None;
E. Mussano,
None;
M. Apaz,
None;
A. Quinteros,
None;
A. Capuccio,
None;
M. De La Sota,
None;
M. Larroude,
None;
A. Granel,
None;
O. Rillo,
None;
E. Soriano,
None;
G. Citera,
AstraZeneca,
5;
D. Dubinsky,
None;
M. Delgado,
None;
A. Alvarez,
None;
G. Gómez,
None;
G. Casado,
None;
S. Aguero,
None;
M. Sacnum,
None;
M. Garcia,
None;
S. Soares de Souza,
None;
E. J. Velozo,
None;
C. Paruolo,
None;
M. P. Diaz,
None;
E. Cavillion,
None;
J. C. Barreira,
None;
G. Gómez,
None;
E. Scheines,
None.
« Back to 2014 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/opportunistic-infections-in-patients-treated-with-biologic-drug-therapy/