Increased risk of opportunistic infection in early rheumatoid arthritis

Hyoungyoung Kim, Soo-Kyung Cho, Jiyoung Lee, Sang Cheol Bae, Yoon-Kyoung Sung

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: To estimate incidence rate (IR) and risk factors for opportunistic infections (OI) in early rheumatoid arthritis (RA) patients. Methods: Retrospective cohorts were identified in the Korean National Claims Database. Incident RA cases were recruited in 2010 (n = 14 081). Follow up was ended at the time of development of new OI or at the date of last visit within 12 months of diagnosis. The IR and standardized incidence ratio (SIR) of OI in early and overall RA (n = 226 838) over a year were calculated. A multivariable regression model was used to identify risk factors for OI in early RA. Results: The IR of OI in early and overall RA were 3.81/100 and 3.67/100 person-years, respectively. The SIR for OI in early RA was 1.14 (95% CI, 1.05-1.23). Herpes zoster (SIR = 1.12, 95% CI, 1.03-1.22) and candidiasis (SIR = 2.40, 95% CI, 1.55-3.54) were common in early RA. Age (50 < age ≤ 60 [OR 1.74, 95% CI, 1.30-2.33], 60 < age ≤ 70 [OR 1.85, 95% CI, 1.36-2.52], age > 70 [OR 1.89, 95% CI, 1.34-2.68]), female sex (OR 1.40, 95% CI, 1.12-1.74), comorbidities (one comorbidity [OR 1.53, 95% CI, 1.24-1.89], ≥ two comorbidities [OR 1.84, 95% CI, 1.47-2.29]), and corticosteroid use of 5 mg/d or more (OR 1.38, 95% CI, 1.13-1.69) were significantly associated with increased risk of OI in early RA. Conclusion: Opportunistic infections, especially for herpes zoster and candidiasis, tend to occur more often in early RA than in overall RA. Age, female sex, comorbidities and corticosteroid use are related to increased OI in early RA patients.

Original languageEnglish
Pages (from-to)1239-1246
Number of pages8
JournalInternational Journal of Rheumatic Diseases
Volume22
Issue number7
DOIs
StatePublished - 2019 Jul 1

Fingerprint

Opportunistic Infections
Rheumatoid Arthritis
Incidence
Comorbidity
Candidiasis
Herpes Zoster
Adrenal Cortex Hormones
Databases

Keywords

  • corticosteroid
  • disease-modifying antirheumatic drugs (biologic)
  • opportunistic infections
  • rheumatoid arthritis

Cite this

@article{c3a5a46f544e43a6b75641e42a840851,
title = "Increased risk of opportunistic infection in early rheumatoid arthritis",
abstract = "Aim: To estimate incidence rate (IR) and risk factors for opportunistic infections (OI) in early rheumatoid arthritis (RA) patients. Methods: Retrospective cohorts were identified in the Korean National Claims Database. Incident RA cases were recruited in 2010 (n = 14 081). Follow up was ended at the time of development of new OI or at the date of last visit within 12 months of diagnosis. The IR and standardized incidence ratio (SIR) of OI in early and overall RA (n = 226 838) over a year were calculated. A multivariable regression model was used to identify risk factors for OI in early RA. Results: The IR of OI in early and overall RA were 3.81/100 and 3.67/100 person-years, respectively. The SIR for OI in early RA was 1.14 (95{\%} CI, 1.05-1.23). Herpes zoster (SIR = 1.12, 95{\%} CI, 1.03-1.22) and candidiasis (SIR = 2.40, 95{\%} CI, 1.55-3.54) were common in early RA. Age (50 < age ≤ 60 [OR 1.74, 95{\%} CI, 1.30-2.33], 60 < age ≤ 70 [OR 1.85, 95{\%} CI, 1.36-2.52], age > 70 [OR 1.89, 95{\%} CI, 1.34-2.68]), female sex (OR 1.40, 95{\%} CI, 1.12-1.74), comorbidities (one comorbidity [OR 1.53, 95{\%} CI, 1.24-1.89], ≥ two comorbidities [OR 1.84, 95{\%} CI, 1.47-2.29]), and corticosteroid use of 5 mg/d or more (OR 1.38, 95{\%} CI, 1.13-1.69) were significantly associated with increased risk of OI in early RA. Conclusion: Opportunistic infections, especially for herpes zoster and candidiasis, tend to occur more often in early RA than in overall RA. Age, female sex, comorbidities and corticosteroid use are related to increased OI in early RA patients.",
keywords = "corticosteroid, disease-modifying antirheumatic drugs (biologic), opportunistic infections, rheumatoid arthritis",
author = "Hyoungyoung Kim and Soo-Kyung Cho and Jiyoung Lee and Bae, {Sang Cheol} and Yoon-Kyoung Sung",
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Increased risk of opportunistic infection in early rheumatoid arthritis. / Kim, Hyoungyoung; Cho, Soo-Kyung; Lee, Jiyoung; Bae, Sang Cheol; Sung, Yoon-Kyoung.

In: International Journal of Rheumatic Diseases, Vol. 22, No. 7, 01.07.2019, p. 1239-1246.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Increased risk of opportunistic infection in early rheumatoid arthritis

AU - Kim, Hyoungyoung

AU - Cho, Soo-Kyung

AU - Lee, Jiyoung

AU - Bae, Sang Cheol

AU - Sung, Yoon-Kyoung

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Aim: To estimate incidence rate (IR) and risk factors for opportunistic infections (OI) in early rheumatoid arthritis (RA) patients. Methods: Retrospective cohorts were identified in the Korean National Claims Database. Incident RA cases were recruited in 2010 (n = 14 081). Follow up was ended at the time of development of new OI or at the date of last visit within 12 months of diagnosis. The IR and standardized incidence ratio (SIR) of OI in early and overall RA (n = 226 838) over a year were calculated. A multivariable regression model was used to identify risk factors for OI in early RA. Results: The IR of OI in early and overall RA were 3.81/100 and 3.67/100 person-years, respectively. The SIR for OI in early RA was 1.14 (95% CI, 1.05-1.23). Herpes zoster (SIR = 1.12, 95% CI, 1.03-1.22) and candidiasis (SIR = 2.40, 95% CI, 1.55-3.54) were common in early RA. Age (50 < age ≤ 60 [OR 1.74, 95% CI, 1.30-2.33], 60 < age ≤ 70 [OR 1.85, 95% CI, 1.36-2.52], age > 70 [OR 1.89, 95% CI, 1.34-2.68]), female sex (OR 1.40, 95% CI, 1.12-1.74), comorbidities (one comorbidity [OR 1.53, 95% CI, 1.24-1.89], ≥ two comorbidities [OR 1.84, 95% CI, 1.47-2.29]), and corticosteroid use of 5 mg/d or more (OR 1.38, 95% CI, 1.13-1.69) were significantly associated with increased risk of OI in early RA. Conclusion: Opportunistic infections, especially for herpes zoster and candidiasis, tend to occur more often in early RA than in overall RA. Age, female sex, comorbidities and corticosteroid use are related to increased OI in early RA patients.

AB - Aim: To estimate incidence rate (IR) and risk factors for opportunistic infections (OI) in early rheumatoid arthritis (RA) patients. Methods: Retrospective cohorts were identified in the Korean National Claims Database. Incident RA cases were recruited in 2010 (n = 14 081). Follow up was ended at the time of development of new OI or at the date of last visit within 12 months of diagnosis. The IR and standardized incidence ratio (SIR) of OI in early and overall RA (n = 226 838) over a year were calculated. A multivariable regression model was used to identify risk factors for OI in early RA. Results: The IR of OI in early and overall RA were 3.81/100 and 3.67/100 person-years, respectively. The SIR for OI in early RA was 1.14 (95% CI, 1.05-1.23). Herpes zoster (SIR = 1.12, 95% CI, 1.03-1.22) and candidiasis (SIR = 2.40, 95% CI, 1.55-3.54) were common in early RA. Age (50 < age ≤ 60 [OR 1.74, 95% CI, 1.30-2.33], 60 < age ≤ 70 [OR 1.85, 95% CI, 1.36-2.52], age > 70 [OR 1.89, 95% CI, 1.34-2.68]), female sex (OR 1.40, 95% CI, 1.12-1.74), comorbidities (one comorbidity [OR 1.53, 95% CI, 1.24-1.89], ≥ two comorbidities [OR 1.84, 95% CI, 1.47-2.29]), and corticosteroid use of 5 mg/d or more (OR 1.38, 95% CI, 1.13-1.69) were significantly associated with increased risk of OI in early RA. Conclusion: Opportunistic infections, especially for herpes zoster and candidiasis, tend to occur more often in early RA than in overall RA. Age, female sex, comorbidities and corticosteroid use are related to increased OI in early RA patients.

KW - corticosteroid

KW - disease-modifying antirheumatic drugs (biologic)

KW - opportunistic infections

KW - rheumatoid arthritis

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