P1206Some potential risk factors for thromboembolic stroke in patients with rheumatoid arthritis and paroxysmal atrial fibrillation

BackgroundGlucocorticoids (GCs) suppress endogenous cortisol levels which can lead to adrenal insufficiency (AI). The frequency of GC-induced AI remains unclear. In this cross-sectional study, low morning salivary cortisol (MSC) levels were used as a measure of adrenal function. The study aim was to investigate the prevalence of low MSC in patients with rheumatoid arthritis (RA) currently and formerly exposed to oral GCs, and the association with potential risk factors.MethodsSample collection was nested within UK primary care electronic health records (from the Clinical Practice Research Datalink). Participants were patients with RA with at least one prescription for oral GCs in the past 2 years. Self-reported oral GC use was used to define current use and current dose; prescription data were used to define exposure duration. MSC was determined from saliva samples; 5 nmol/L was the cut-off for low MSC. The prevalence of low MSC was estimated, and logistic regression was used to assess the association with potential risk factors.Results66% of 38 current and 11 % of 38 former GC users had low MSC. Among former users with low MSC, the longest time since GC withdrawal was 6 months. Current GC dose, age and RA duration were significantly associated with increased risk of low MSC.ConclusionThe prevalence of low MSC among current GC users is high, and MSC levels may remain suppressed for several months after GC withdrawal. Clinicians should therefore consider the risk of suppressed cortisol and remain vigilant for symptoms of AI following GC withdrawal.

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Rheumatoid Arthritis and its treatment: potential risk factors of osteonecrosis of the jaw besides bisphosphonates

10.47660/cbr.2021.1780 ◽

2021 ◽

Author(s):

Carolina Teixeira Cidon ◽

Thais Helena Bonini Gorayeb ◽

Maria Eugênia Teixeira Bicalho ◽

Renata Lys Pinheiro de Mello ◽

Victor Caires Tadeu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Potential Risk ◽

Osteonecrosis Of The Jaw ◽

Potential Risk Factors

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The Risk Factors for Nosocomial Infection in Chinese Patients with Active Rheumatoid Arthritis in Shanghai

ISRN Rheumatology ◽

10.5402/2012/215692 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Wei-Lin Xie ◽

Zhuo-Ling Li ◽

Zhen Xu ◽

Huan-Ru Qu ◽

Luan Xue ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Serum Albumin ◽

Potential Risk ◽

Active Rheumatoid Arthritis ◽

Chinese Patients ◽

Reactive Protein ◽

Cell Counts ◽

Potential Risk Factors ◽

White Blood Cell Counts

Objective. To analyse the potential risk factors of nosocomial infections in patients with active rheumatoid arthritis (RA). Methods. A total of 2452 active RA patients at Hospitals in Shanghai between January 2009 and February 2011 were analyzed. Their demographic and clinical characteristics were compared with those without infection, and the potential risk factors were determined by logistic regression analysis. Results. Multivariate analysis indicated the gender (OR=0.70, 95% CI 0.53–0.92), duration in hospital (OR=1.03, 95%CI 1.01–1.05), number of organs involved (OR=0.82, 95%CI 0.72–0.92), number of disease-modifying antirheumatic drugs ((DMARDs) (OR=1.22, 95%CI 1.061–1.40)), corticosteroid therapy (OR=1.02, 95%CI 1.01–1.03), peripheral white blood cell counts ((WBC) (OR=1.04, 95%CI 1.00–1.08)), levels of serum albumin (OR=0.98, 95%CI 0.97–0.99), and C-reactive protein ((CRP) (OR=1.03, 95%CI 1.01–1.04)) that were significantly associated with the risk of infections. Conclusion. The female patients, longer hospital stay, more organs involved, more DMARDs, corticosteroid usage, high counts of WBC, lower serum albumin, and higher serum CRP were independent risk factors of infections in active RA patients.

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Evaluation of the Risk of Atrial Fibrillation/Flutter Among Patients Initiating Ibrutinib

Blood ◽

10.1182/blood-2018-99-117074 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 4821-4821

Author(s):

Anju Nohria ◽

Lisa Rosenblatt ◽

Xianying Pan ◽

Arpita Sharma

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Median Duration ◽

Potential Risk ◽

Index Date ◽

Cox Regression ◽

Administrative Claims ◽

Employment Equity ◽

Potential Risk Factors ◽

Equity Ownership

Abstract INTRODUCTION: Ibrutinib is a Bruton's tyrosine kinase inhibitor that is used to treat chronic lymphocytic leukemia and other hematologic malignancies. Atrial fibrillation/flutter (AF) is emerging as an adverse effect of ibrutinib therapy. The objective of this analysis was to evaluate the incidence of new AF in a real-world sample of patients initiating ibrutinib and exploring potential risk factors of AF in this population. METHODS: A retrospective cohort study of patients (age>=18) initiating ibrutinib between 01 Nov 2013 and 30 Sep 2017 was conducted using four US administrative claims databases. The databases used were MarketScan - Commercial and Medicare Supplemental Database, Optum Clinformatics Data Mart, PharmetricsPlus Adjudicated Claims Database and Humana. Patient cohorts were identified independently from each of the databases and were combined for pooled analyses after ensuring a minimum patient overlap of less than 5% among databases. The date of first prescription of ibrutinib was considered as the index date. Patients were followed from the index date to the end of index ibrutinib therapy (ibrutinib discontinuation date, follow-up end, or study end, whichever was earliest) to identify the diagnosis of new AF. Patients with an AF diagnosis prior to the index date were excluded. Baseline characteristics (including demographics, comorbidities, type of cancer and Charlson Comorbidity Index (CCI) score) were evaluated. Incident rates were calculated as number of AF events per 100 person-years and were stratified by age and gender. Cox regression models were used to estimate hazard ratios and assess potential risk factors for AF among patients receiving ibrutinib. RESULTS: The study examined outcomes in 7,276 patients treated with ibrutinib, including 4,650 (63.91%) males and 2,626 (36.09%) females, followed for a median duration of 161 days (~5.3 months). The overall incidence rate of AF was 12.5 per 100 person-years (Table 1). The median duration until AF diagnosis was 117 days (~4 months). Males were at higher risk of developing AF than females; a similar trend was observed in patients age >75 compared to younger patients. Ibrutinib patients with congestive heart failure (CHF), peripheral vascular disease (PVD) or a moderate CCI score (3-4) at baseline were at higher risk of developing AF. CONCLUSION: The incidence of AF in patients treated with ibrutinib is substantial. Older age, male gender, and baseline comorbidities (CHF and PVD) notably affect the risk of developing AF in these patients. AF should be considered when monitoring for adverse events in patients treated with ibrutinib. Disclosures Nohria: Takeda Oncology: Consultancy; Amgen: Research Funding. Rosenblatt:Bristol-Myers Squibb: Employment, Equity Ownership. Pan:Bristol-Myers Squibb: Employment, Equity Ownership. Sharma:Mu Sigma: Employment; Bristol-Myers Squibb: Consultancy.

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Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645677 ◽

1990 ◽

Vol 63 (01) ◽

pp. 013-015 ◽

Cited By ~ 15

Author(s):

E J Johnson ◽

C R M Prentice ◽

L A Parapia

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Potential Risk ◽

Antithrombin Iii ◽

Arterial Disease ◽

Coagulation System ◽

Early Age ◽

Arterial Thromboembolism ◽

Potential Risk Factors ◽

Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

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