Overall infection risk in rheumatoid arthritis during treatment with abatacept, rituximab and tocilizumab; an observational cohort study

Rheumatology ◽  
2019 ◽  
Vol 59 (8) ◽  
pp. 1949-1956 ◽  
Author(s):  
Kathrine L Grøn ◽  
Bente Glintborg ◽  
Mette Nørgaard ◽  
Frank Mehnert ◽  
Mikkel Østergaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Routine Care ◽  
Incidence Rates ◽  
Observational Cohort Study ◽  
Tnf Inhibitor ◽  
Observational Cohort ◽  
Never Smokers ◽  
And Gender ◽  
Rate Ratios

Abstract Objectives Most infections in patients with RA are treated in primary care with antibiotics. A small fraction require hospitalization. Only a few studies exist regarding the overall risk of infection (i.e. prescription of antibiotics or hospitalization due to infection) in patients initiating non-TNF-inhibitor therapy. In Danish RA patients initiating abatacept, rituximab and tocilizumab treatment in routine care, the aims were to compare adjusted incidence rates (IR) of infections and to estimate relative risk of infections across the drugs during 0–12 and 0–24 months. Methods This was an observational cohort study including all RA patients in the DANBIO registry starting a non-TNF-inhibitor from 2010 to 2017. Infections were defined as a prescription of antibiotics or hospitalization due to infection. Prescriptions, comorbidities and infections were captured through linkage to national registries. IRs of infections (age, gender adjusted) and rate ratios (as estimates of RR (relative risk)), adjusted for additional covariates) (Poisson regression) were calculated. Results We identified 3696 treatment episodes (abatacept 1115, rituximab 1017, tocilizumab 1564). At baseline, rituximab users were older and had more previous cancer. During 0–12 months, 1747 infections occurred. Age and gender-adjusted IRs per 100 person-years were as follows: abatacept: 76 (95% CI: 69, 84); rituximab: 87 (95% CI: 79, 96); tocilizumab: 77 (95% CI: 71, 84). Adjusted RRs were 0.94 (95% CI: 0.81, 1.08) for abatacept and 0.94 (95% CI: 0.81, 1.03) for tocilizumab compared with rituximab and 1.00 (95% CI: 0.88, 1.14) for abatacept compared with tocilizumab. RRs around 1 were observed after 24 months. Switchers and ever smokers had higher risk compared with biologic-naïve and never smokers, respectively. Conclusion Overall infections were common in non-TNF-inhibitor-treated RA patients, with a tendency towards rituximab having the highest risk, but CIs were wide in all analyses. Confounding by indication may at least partly explain any differences.

scholarly journals Risk of human papillomavirus-related cancers among kidney transplant recipients and patients receiving chronic dialysis - an observational cohort study

2021 ◽  
Author(s):  
Lars Skov Dalgaard ◽  
Ulrik Fassel ◽  
Lars Jørgen Østergaard ◽  
Bente Jespersen ◽  
Ole Schmeltz Søgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Human Papillomavirus ◽  
Incidence Rates ◽  
Observational Cohort Study ◽  
Excess Risk ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Observational Cohort ◽  
Esrd Patients ◽  
Population Controls

Background Individuals with end-stage renal disease (ESRD) have excess risk of various cancer types. However, the total burden of human papillomavirus-related cancers remains unknown. Methods We performed a nationwide observational cohort study during 1994–2010. For each person with ESRD, we sampled 19 population controls (without ESRD) matched on age, gender and municipality. Participants were followed until first diagnosis of human papillomavirus-related cancer, death, emigration, or 31 December 2010, whichever came first. Human papillomavirus-related cancers were extracted from Danish medical administrative databases. We considered cancers of the cervix, vulva, vagina, penis, anus, and subsets of head and neck cancers as human papillomavirus-related. We calculated incidence rates of human papillomavirus-related cancer and used Poisson regression to identify risk factors for human papillomavirus-related cancer. Results Among 12,293 persons with ESRD and 229,524 population controls we identified 62 and 798 human papillomavirus-related cancers, respectively. Incidence rates of human papillomavirus-related- cancer were 102 per 100,000 person-years (95% confidence interval [CI]; 79.5-131) among persons with ESRD and 40.8 per 100,000 person-years (95% CI; 38.1-43.7) among population controls. ESRD patients had 4.54 (95% CI, 2.48-8.31) fold increased risk of anal cancer and 5.81 fold (95% CI; 3.36-10.1) increased risk of vulvovaginal cancer. Adjusted for age, comorbidity, and sex, ESRD patients had 2.41 (95% CI; 1.83-3.16) fold increased risk of any human papillomavirus-related cancer compared with population controls. Compared with dialysis patients renal transplant recipients had an age-adjusted non-significant 1.53 (95% CI, 0.91-2.58) fold higher risk of human papillomavirus-related cancer. Conclusions Persons with ESRD have excess risk of potentially vaccine-preventable human papillomavirus-related cancers.

scholarly journals The incidence of distal radius fractures in a Swedish pediatric population - an observational cohort study of 90 970 individual fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hanna Südow ◽  
Cecilia Mellstrand Navarro
Keyword(s):  
Cohort Study ◽  
Distal Radius ◽  
Pediatric Population ◽  
Incidence Rates ◽  
Observational Cohort Study ◽  
The Body ◽  
Fracture Incidence ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Observational Cohort

Abstract Background 40–50 % of all boys and 30–40 % of girls suffer from at least one fracture during childhood. A quarter of these fractures affects the wrist, making it the worst affected part of the body. Children often sustain the injury during play or sport activities. There has been a lifestyle change among European children during the last decades, and there is reason to believe that fracture incidence is changing. Methods For the purpose of this observational cohort study registry data was retrieved from the Swedish National Patient Register for all pediatric patients registered with a distal radius fracture during the period 2005–2013. Incidence rates were calculated for each year using data from Statistic Sweden on population size by age and gender. Results 90 970 distal radius fractures were identified. The mean age at the time of fracture was 10 years. In ages 10–17 the proportion of male patients was significantly larger. Seasonal variations were detected with peak incidences in May and September. A decreasing total fracture incidence was observed during the study period. Conclusions The incidence of distal radius fractures in a population 0–17 years in Sweden was higher among male than in female patients. The incidence was lower in 2008–2013 as compared to 2005. Further studies are necessary to reveal if the incidence will continue to decrease.

scholarly journals Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men: Protocol for an Observational Cohort Study (Preprint)

2020 ◽  
Author(s):  
James E Egan ◽  
Sabina A Haberlen ◽  
Steven Meanley ◽  
Deanna Ware ◽  
Andre L Brown ◽  
...  
Keyword(s):  
Cohort Study ◽  
Sexual Minority ◽  
Healthy Aging ◽  
Observational Cohort Study ◽  
Sexual Minority Men ◽  
Health And Illness ◽  
Observational Cohort ◽  
Minority Men ◽  
And Gender ◽  
Sex With Men

BACKGROUND With the graying of sexual and gender minority communities and the growing number of people aged ≥50 years living with HIV, it is increasingly important to understand resilience in the context of the psychosocial aspects of aging and aging well. OBJECTIVE This paper aims to describe the methods and sample for the <i>Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men</i> study<i>.</i> METHODS This observational cohort study was conducted within the Multisite AIDS Cohort Study (MACS) and was designed to explore resiliencies to explain patterns of health and illness among middle-aged and older sexual minority men. To be eligible, a participant had to be an active participant in the MACS, be at least 40 years of age as of April 1, 2016, and report any sex with another man since enrollment in the MACS. RESULTS Eligible participants (N=1318) completed six biannual surveys between April 2016 and April 2019. The mean age of the sample was 59.6 years (range 40-91 years). The sample was mostly White, educated, gay-identified, and included both HIV-positive (656/1318, 49.77%) and HIV-negative (662/1318, 50.23%) men. CONCLUSIONS Understanding resiliencies in aging is a critical springboard for the development of more holistic public health theories and interventions that support healthy aging among older sexual minority men. INTERNATIONAL REGISTERED REPORT RR1-10.2196/25750

scholarly journals Risk of human papillomavirus-related cancers among kidney transplant recipients and patients receiving chronic dialysis - an observational cohort study

2021 ◽  
Author(s):  
Lars Skov Dalgaard ◽  
Ulrik Fassel ◽  
Lars Jørgen Østergaard ◽  
Bente Jespersen ◽  
Ole Schmeltz Søgaard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Human Papillomavirus ◽  
Incidence Rates ◽  
Observational Cohort Study ◽  
Excess Risk ◽  
Transplant Recipients ◽  
Increased Risk ◽  
Observational Cohort ◽  
Esrd Patients ◽  
Population Controls

Background Individuals with end-stage renal disease (ESRD) have excess risk of various cancer types. However, the total burden of human papillomavirus-related cancers remains unknown. Methods We performed a nationwide observational cohort study during 1994–2010. For each person with ESRD, we sampled 19 population controls (without ESRD) matched on age, gender and municipality. Participants were followed until first diagnosis of human papillomavirus-related cancer, death, emigration, or 31 December 2010, whichever came first. Human papillomavirus-related cancers were extracted from Danish medical administrative databases. We considered cancers of the cervix, vulva, vagina, penis, anus, and subsets of head and neck cancers as human papillomavirus-related. We calculated incidence rates of human papillomavirus-related cancer and used Poisson regression to identify risk factors for human papillomavirus-related cancer. Results Among 12,293 persons with ESRD and 229,524 population controls we identified 62 and 798 human papillomavirus-related cancers, respectively. Incidence rates of human papillomavirus-related- cancer were 102 per 100,000 person-years (95% confidence interval [CI]; 79.5-131) among persons with ESRD and 40.8 per 100,000 person-years (95% CI; 38.1-43.7) among population controls. ESRD patients had 4.54 (95% CI, 2.48-8.31) fold increased risk of anal cancer and 5.81 fold (95% CI; 3.36-10.1) increased risk of vulvovaginal cancer. Adjusted for age, comorbidity, and sex, ESRD patients had 2.41 (95% CI; 1.83-3.16) fold increased risk of any human papillomavirus-related cancer compared with population controls. Compared with dialysis patients renal transplant recipients had an age-adjusted non-significant 1.53 (95% CI, 0.91-2.58) fold higher risk of human papillomavirus-related cancer. Conclusions Persons with ESRD have excess risk of potentially vaccine-preventable human papillomavirus-related cancers.

scholarly journals The association of serum gamma-glutamyltransferase and the incidence of type 2 diabetes mellitus based on propensity score matching: a retrospective observational cohort study

2020 ◽  
Author(s):  
Buyuan Dong ◽  
Ziwei Ji ◽  
Leye He ◽  
Hao Chen ◽  
Mengxia Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Japanese Population ◽  
Observational Cohort Study ◽  
Gamma Glutamyltransferase ◽  
Increased Risk ◽  
Gender And Age ◽  
Observational Cohort ◽  
And Gender ◽  
Retrospective Observational Cohort Study

Abstract Background: Previous studies reported that gamma-glutamyltransferase (GGT) may play an important role in the development of diabetes. The purpose of this study is to demonstrate that GGT is an independent risk factor for diabetes and to explore whether the association between GGT and the incidence of diabetes is affected by age and gender in the general Japanese population.Methods: This study is a retrospective observational cohort study. The study included 15464 men and women with an average age of 43.71 years from the Japanese health checkup program at Murakami Memorial Hospital from 2004 to 2015. The serum gamma-glutamyltransferase was stratified by quartiles. Patients were stratified by gender and age. Results: After adjusting for potential confounders, each additional standard deviation (SD) of GGT increases the risk of diabetes by 9%. The hazard ratio (HR) is 1.09 and the confidence interval (CI) is (1.01, 1.17). Participants in the fourth quartiles (Q4,≥ 22IU/L) had a higher risk of diabetes than the first to third quartiles (Q1-Q3) of GGT (HR: 1.47, 95 % CI: 1.15-1.87). Compared with males with lower GGT activity, males aged 40 to 50 years with GGT activity in the fourth quantile had a 53% increased risk of diabetes mellitus. Conclusions: GGT was positively correlated with the incidence of diabetes in the Japanese population. Especially in males aged 40-50 y, the higher the GGT, the higher the risk of developing diabetes.

scholarly journals The incidence of distal radius fractures in a Swedish pediatric population - an observational cohort study of 90 970 individual fractures

2021 ◽  
Author(s):  
Hanna Südow ◽  
Cecilia Mellstrand Navarro
Keyword(s):  
Cohort Study ◽  
Distal Radius ◽  
Pediatric Population ◽  
Incidence Rates ◽  
Observational Cohort Study ◽  
The Body ◽  
Fracture Incidence ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Observational Cohort

Abstract Background 40-50% of all boys and 30-40% of girls suffer from at least one fracture during childhood. A quarter of these fractures affects the wrist, making it the worst affected part of the body. Children often sustain the injury during play or sport activities. There has been a lifestyle change among European children during the last decades, and there is reason to believe that fracture incidence is changing. Methods For the purpose of this observational cohort study registry data was retrieved from the Swedish National Patient Register for all pediatric patients registered with a distal radius fracture during the period 2005 – 2013. Incidence rates were calculated for each year using data from Statistic Sweden on population size by age and gender. Results 90 970 distal radius fractures were identified. The mean age at the time of fracture was 10 years. In ages 10-17 the proportion of male patients was significantly larger. Seasonal variations were detected with peak incidences in May and September. A decreasing total fracture incidence was observed during the study period. Conclusion The incidence of distal radius fractures in a population 0 – 17 years in Sweden was higher among male than in female patients. The incidence was lower in 2008 – 2013 as compared to 2005. Further studies are necessary to reveal if the incidence will continue to decrease.

scholarly journals Mortality in patients with diabetes mellitus and Addison’s disease: a nationwide, matched, observational cohort study

2017 ◽  
Vol 176 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Dimitrios Chantzichristos ◽  
Anders Persson ◽  
Björn Eliasson ◽  
Mervete Miftaraj ◽  
Stefan Franzén ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Relative Risk ◽  
Cause Of Death ◽  
Diabetes Complications ◽  
Addison’S Disease ◽  
Observational Cohort Study ◽  
Risk Of Death ◽  
Patients With Diabetes ◽  
Observational Cohort

Objective Our hypothesis was that patients with diabetes mellitus obtain an additional risk of death if they develop Addison’s disease (AD). Design and methods Nationwide, matched, observational cohort study cross-referencing the Swedish National Diabetes Register with Inpatient, Cancer and Cause of Death Registers in patients with diabetes (type 1 and 2) and AD and matched controls with diabetes. Clinical characteristics at baseline, overall, and cause-specific mortality were assessed. The relative risk of death was assessed using a Cox proportional hazards regression model. Results Between January 1996 and December 2012, 226 patients with diabetes and AD were identified and matched with 1129 controls with diabetes. Median (interquartile range) follow-up was 5.9 (2.7–8.6) years. When patients with diabetes were diagnosed with AD, they had an increased frequency of diabetes complications, but both medical history of cancer and coronary heart disease did not differ compared with controls. Sixty-four of the 226 patients with diabetes and AD (28%) died, while 112 of the 1129 controls (10%) died. The estimated relative risk increase (hazard ratio) in overall mortality in the diabetes and AD group was 3.89 (95% confidence interval 2.84–5.32) compared with controls with diabetes. The most common cause of death was cardiovascular in both groups, but patients with diabetes and AD showed an increased death rate from diabetes complications, infectious diseases and unknown causes. Conclusions Patients with the rare combination of diabetes and AD showed a markedly increased mortality and died more frequently from infections and unknown causes than patients with diabetes alone. Improved strategy for the management of this combination of metabolic disorders is needed.

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