Severe Respiratory Infections in Rheumatoid Arthritis Patients with Biologic Therapy: Comparative Study Between Vaccinated and Non Vaccinated Patients

Lucia Cristina Dominguez Casas¹, Paz Rodriguez-Cundin², Trinidad Dierssen³, Miguel Ángel gonzalez-Gay⁴ and Ricardo Blanco⁵, ¹Hospital Universtario San Agustin, Oviedo, Spain, ²Hospital Universitario Marqués de Valdecilla, Santander, Spain, ³University of Cantabria, Santander, Spain, ⁴Research group on Genetic Epidemiology and Atherosclerosis in Systemic Diseases and in Metabolic Bone Diseases of the Musculoskeletal System, IDIVAL, Division of Rheumatology, Hospital Universitario Marqués de Valdecilla; School of Medicine, Universidad de Cantabria, Santander, Spain. Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, ⁵Hospital Universitario Marqués de Valdecilla, Santadner, Spain

Meeting: ACR Convergence 2021

Keywords: Biologicals, Infection, rheumatoid arthritis

Session Information

Date: Tuesday, November 9, 2021

Title: RA – Diagnosis, Manifestations, & Outcomes Poster IV: Outcomes, Trajectory of Disease, & Epidemiology (1645–1673)

Session Type: Poster Session D

Session Time: 8:30AM-10:30AM

Background/Purpose: Rheumatoid arthritis (RA) patients are at increased risk of severe infections due to the disease itself, and the immunosuppressive treatment. Vaccination programs are designed to decrease the risk of infections.

Our aim was to assess a) the incidence of severe respiratory infections and b) to compare the risk between vaccinated and non vaccinated patients in patients with RA treated with biologic therapy (BT)

Methods: Observational study of 431 patients diagnosed with RA that iniciated BT. One group of patients participated in the vaccination program of the Preventive Medicina and Rheumatologúa departments of our hospital from October 2011 to October 2016 (Group 1). The other group was not included in the vaccination program (Group 2). The follow-up was made until June 2017 with a minimum follow-up period of 8 months and a maximum of 5.5 years.

Information on severe respiratory infections, defined as those that required hospitalization or at least one dose of intravenous antibiotic treatment at the emergency room, was retrieved from the hospital medical records.

Results: We studied 431 patients (335 women/96 men); mean age 63.4±13.7 years. In the vaccination program (group 1) were included 299 (69.4%) patients and in the group 2; 132 patients (30.6%). The main features of both groups are summarized in the TABLE.

During the follow-up, we registered 299 hospital admissions due to severe respiratory infections in both groups (incidence density 9,9 (95% CI: 6,9-13,6).

In group 1, vaccinated patients, this incidence density was reduced to 7,1 (95% CI: 4,1-11,6). Figure.

The vaccination program reduced the general incidence of severe respiratory infection in 44%.

Conclusion: RA patients with BT included in the vaccination program present a lower incidence of severe respiratory infections compared with non vaccinated patients.

TABLE. Main general features at BT onset

FIGURE.

Disclosures: L. Dominguez Casas, None; P. Rodriguez-Cundin, None; T. Dierssen, None; M. gonzalez-Gay, None; R. Blanco, None.

To cite this abstract in AMA style:

Dominguez Casas L, Rodriguez-Cundin P, Dierssen T, gonzalez-Gay M, Blanco R. Severe Respiratory Infections in Rheumatoid Arthritis Patients with Biologic Therapy: Comparative Study Between Vaccinated and Non Vaccinated Patients [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/severe-respiratory-infections-in-rheumatoid-arthritis-patients-with-biologic-therapy-comparative-study-between-vaccinated-and-non-vaccinated-patients/. Accessed .

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