ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1308

Opportunistic Infections in Patients with Rheumatoid Arthritis Treated with Rituximab : Data From the Autoimmunity and Rituximab Registry

Jacques-Eric Gottenberg1, Philippe Ravaud2, Thomas Bardin3, Patrice Cacoub4, Alain G. Cantagrel5, Bernard Combe6, Maxime Dougados7, Rene-Marc Flipo8, Bertrand Godeau9, Loic Guillevin10, Xavier X. Le Loet11, Eric Hachulla12, Thierry Schaeverbeke13, Jean Sibilia14, Isabelle Pane15, Gabriel Baron16 and Xavier Mariette17, 1Rheumatology, Strasbourg University Hospital, Strasbourg, France, 2Epidemiology, Hopital Hotel Dieu, Paris Descartes University, Paris, France, 3Rheumatology, Hôpital Lariboisière, Paris, France, 4Internal Medicine, Assistance Publique-Hôpitaux de Paris, Hopital Pitié-Salpétrière, Paris, France, 5Rheumatology, Place du Docteur Baylac, Toulouse, France, 6Rheumatology, Hopital Lapeyronie, Montpellier, France, 7Rheumatology B Department, Paris-Descartes University, Cochin Hospital, Paris, France, 8Rheumatology, Hopital R Salengro CHRU, Lille, France, 9Internal Medicine, University of Paris, AP-HP, Hôpital Mondor Créteil, Creteil, France, 10Department of Internal Medicine, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, AP–HP, Université Paris Descartes, Paris, France, Paris, France, 11Rheumatology Department, CHU de ROUEN, Rouen, France, 12Department of Internal Medicine, Claude Huriez University Hospital, Lille, France, 13Service de Rhumatologie, Groupe Hospitalier Pellegrin, Bordeaux, France, 14Rheumatology, CHU Hautepierre, Strasbourg, France, 15Hotel Dieu University Hospital Paris, Hotel Dieu University Hospital Paris, Paris, France, 16Epidemiology, Strasbourg, France, 17Rheumatology, Université Paris-Sud, Le Kremlin Bicetre, France

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: , ,

Session Information

Title: Rheumatoid Arthritis Treatment - Small Molecules, Biologics and Gene Therapy

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Therapy  with biological agents may be associated with opportunistic infections (OIs). Data on the occurrence of OIs in patients with RA treated with rituximab (RTX) are limited.

Objective To describe the spectrum of OIs associated with RTX therapy

Methods:

The AutoImmunity and Rituximab (AIR) registry was set up by the French Society of Rheumatology. Patients are  followed up every 6 months during 7 years. Data regarding serious infections are validated by the 2 coordinators of the study using chart copies.

Results:

1975  patients had already  had at least 1 follow-up visit. The follow-up was 4937 patient/years on January 1st, 13 OIs occurred (0.3 OIs/100 patient years).   23.0% of OIs were due to intra-cellular bacterial (1 tuberculosis, 1 atypical mycobacteriosis, 1 non-typhoid salmonellosis), 38.6% were viral (2 severe herpes zoster, 1 varicella, 2 disseminated cytomegalovirus infections), 30.8% were fungal (2 pneumocystosis, 1 echinococcosis, 1 Scedosporium infection) and 7.6% were parasitic (1 disseminated scabies). 1 patient required admission to the intensive care unit and died from herpetic hepatitis.

Conclusion:

Even in real life patients, the risk of tuberculosis remains very low in patients treated with RTX in Western Europe. However, some various and serious OIs, especially those with intracellular micro-organisms, may unfrequently develop in patients receiving RTX. This risk requires to be reevaluated with a longer follow-up .

Disclosure:

J. E. Gottenberg,
None;

P. Ravaud,
None;

T. Bardin,
None;

P. Cacoub,
None;

A. G. Cantagrel,
None;

B. Combe,
None;

M. Dougados,
None;

R. M. Flipo,
None;

B. Godeau,
None;

L. Guillevin,
None;

X. X. Le Loet,
None;

E. Hachulla,
None;

T. Schaeverbeke,
None;

J. Sibilia,
None;

I. Pane,
None;

G. Baron,
None;

X. Mariette,
None.

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