Abstract
Background
To compare the incidence and risk factors of serious infections among patients of seven common rheumatic diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), polymyalgia rheumatica (PMR), Sjögren's syndrome (SS), systemic sclerosis (SSc), systemic vasculitis (VA), and other diffuse connective tissue diseases (oCTD).
Methods
In a retrospective cohort study using large Electronic Health Records (EHR) data, the infection rates of different rheumatic diseases in two years were calculated and variances on risk factors were analyzed using the multivariable Cox model.
Results
Among the overall 46,411 rheumatic patients, 8,308 presented serious hospitalized infections in the following two years (crude infection rates (IR) per 100 patient-years: 8.95, 8.76–9.14). SSc (10.89, 9.61–12.16), VA (10.82, 9.96–11.68), and SLE (10.13, 9.73–10.53) had relatively high IRs, while oCTD was with the lowest IR (7.71, 6.58–8.84). The Cox model identified previous infection (adjusted hazard ratio (HR):1.75, 1.62–1.88, p < 0.001), GCs usage (HR:1.64, 1.52–1.76, p < 0.001), nonbiologic DMARDs usage (HR:1.39, 1.32–1.45, p < 0.001) and congestive heart failure (CHF) (HR:1.42, 1.30–1.56, p < 0.001) as the top-ranked risk factors of infection in the overall population. While some of the variables were shared across subtypes of rheumatic diseases as highly associated risk factors, others varied significantly such as osteoporosis.
Conclusions
Infection rates and risk factors varied among cohorts of different rheumatic diseases. The analytical results may inform distinct strategies and influence clinical decision making to reduce the occurrence of infections.
132. Why Measure Thiopurine Methyltransferase, Good Personalized Medicine or ILL-Considered Habit? A Retrospective Cohort Study of Patients with Rheumatic Diseases