Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study
Abstract Background To analyse the subsequent clinical course of patients with rheumatoid arthritis (RA) who either continued or discontinued biologic agents after hospitalization for infections. Methods We retrospectively reviewed the clinical records of 230 RA patients with 307 hospitalizations fo...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13075-022-02820-y |
| _version_ | 1817970872899600384 |
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| author | Yusuke Kashiwado Chikako Kiyohara Yasutaka Kimoto Shuji Nagano Takuya Sawabe Kensuke Oryoji Shinichi Mizuki Hiroaki Nishizaka Seiji Yoshizawa Shigeru Yoshizawa Tomomi Tsuru Yasushi Inoue Naoyasu Ueda Shun-ichiro Ota Yasuo Suenaga Tomoya Miyamura Yoshifumi Tada Hiroaki Niiro Koichi Akashi Takahiko Horiuchi |
| author_facet | Yusuke Kashiwado Chikako Kiyohara Yasutaka Kimoto Shuji Nagano Takuya Sawabe Kensuke Oryoji Shinichi Mizuki Hiroaki Nishizaka Seiji Yoshizawa Shigeru Yoshizawa Tomomi Tsuru Yasushi Inoue Naoyasu Ueda Shun-ichiro Ota Yasuo Suenaga Tomoya Miyamura Yoshifumi Tada Hiroaki Niiro Koichi Akashi Takahiko Horiuchi |
| author_sort | Yusuke Kashiwado |
| collection | DOAJ |
| description | Abstract Background To analyse the subsequent clinical course of patients with rheumatoid arthritis (RA) who either continued or discontinued biologic agents after hospitalization for infections. Methods We retrospectively reviewed the clinical records of 230 RA patients with 307 hospitalizations for infections under biologic therapy between September 2008 and May 2014 in 15 institutions for up to 18 months after discharge. The risks of RA flares and subsequent hospitalizations for infections from 61 days to 18 months after discharge were evaluated. Results Survival analyses indicated that patients who continued biologic therapy had a significantly lower risk of RA flares (31.4% vs. 60.6%, P < 0.01) and a slightly lower risk of subsequent infections (28.7% vs. 34.5%, P = 0.37). Multivariate analysis showed that discontinuation of biologic therapy, diabetes, and a history of hospitalization for infection under biologic therapy were associated with RA flares. Oral steroid therapy equivalent to prednisolone 5 mg/day or more and chronic renal dysfunction were independent risk factors for subsequent hospitalizations for infections. Conclusions Discontinuation of biologic therapy after hospitalization for infections may result in RA flares. Continuation of biologic therapy is preferable, particularly in patients without immunodeficiency. |
| first_indexed | 2024-04-13T20:39:27Z |
| format | Article |
| id | doaj.art-092362ecdaab40f0b3faa7e9100fe8c8 |
| institution | Directory Open Access Journal |
| issn | 1478-6362 |
| language | English |
| last_indexed | 2024-04-13T20:39:27Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj.art-092362ecdaab40f0b3faa7e9100fe8c82022-12-22T02:30:55ZengBMCArthritis Research & Therapy1478-63622022-06-012411910.1186/s13075-022-02820-yClinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational studyYusuke Kashiwado0Chikako Kiyohara1Yasutaka Kimoto2Shuji Nagano3Takuya Sawabe4Kensuke Oryoji5Shinichi Mizuki6Hiroaki Nishizaka7Seiji Yoshizawa8Shigeru Yoshizawa9Tomomi Tsuru10Yasushi Inoue11Naoyasu Ueda12Shun-ichiro Ota13Yasuo Suenaga14Tomoya Miyamura15Yoshifumi Tada16Hiroaki Niiro17Koichi Akashi18Takahiko Horiuchi19Department of Internal Medicine, Kyushu University Beppu HospitalDepartment of Preventive Medicine, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Internal Medicine, Kyushu University Beppu HospitalDepartment of Rheumatology, Aso Iizuka HospitalDepartment of Rheumatology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors HospitalThe Center for Rheumatic Diseases, Matsuyama Red Cross HospitalThe Center for Rheumatic Diseases, Matsuyama Red Cross HospitalDepartment of Rheumatology, Kitakyushu Municipal Medical CenterDepartment of Rheumatology, Hamanomachi HospitalDepartment of Rheumatology, National Hospital Organization Fukuoka HospitalDepartment of Rheumatology, Med.Co. LTA PS ClinicDepartment of Rheumatology, Japanese Red Cross Fukuoka HospitalDepartment of Rheumatology and Infection, Miyazaki Prefectural Miyazaki HospitalDepartment of Rheumatology, Internal medicine and connective tissue disorders, Shimonoseki City HospitalDepartment of Rheumatology, Beppu Medical Center, NHODepartment of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical CenterDepartment of Rheumatology, Saga University HospitalDepartment of Medical Education, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Internal Medicine, Kyushu University Beppu HospitalAbstract Background To analyse the subsequent clinical course of patients with rheumatoid arthritis (RA) who either continued or discontinued biologic agents after hospitalization for infections. Methods We retrospectively reviewed the clinical records of 230 RA patients with 307 hospitalizations for infections under biologic therapy between September 2008 and May 2014 in 15 institutions for up to 18 months after discharge. The risks of RA flares and subsequent hospitalizations for infections from 61 days to 18 months after discharge were evaluated. Results Survival analyses indicated that patients who continued biologic therapy had a significantly lower risk of RA flares (31.4% vs. 60.6%, P < 0.01) and a slightly lower risk of subsequent infections (28.7% vs. 34.5%, P = 0.37). Multivariate analysis showed that discontinuation of biologic therapy, diabetes, and a history of hospitalization for infection under biologic therapy were associated with RA flares. Oral steroid therapy equivalent to prednisolone 5 mg/day or more and chronic renal dysfunction were independent risk factors for subsequent hospitalizations for infections. Conclusions Discontinuation of biologic therapy after hospitalization for infections may result in RA flares. Continuation of biologic therapy is preferable, particularly in patients without immunodeficiency.https://doi.org/10.1186/s13075-022-02820-yRheumatoid arthritisInfectionBiological therapyAntirheumatic agents |
| spellingShingle | Yusuke Kashiwado Chikako Kiyohara Yasutaka Kimoto Shuji Nagano Takuya Sawabe Kensuke Oryoji Shinichi Mizuki Hiroaki Nishizaka Seiji Yoshizawa Shigeru Yoshizawa Tomomi Tsuru Yasushi Inoue Naoyasu Ueda Shun-ichiro Ota Yasuo Suenaga Tomoya Miyamura Yoshifumi Tada Hiroaki Niiro Koichi Akashi Takahiko Horiuchi Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study Arthritis Research & Therapy Rheumatoid arthritis Infection Biological therapy Antirheumatic agents |
| title | Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study |
| title_full | Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study |
| title_fullStr | Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study |
| title_full_unstemmed | Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study |
| title_short | Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study |
| title_sort | clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection a retrospective observational study |
| topic | Rheumatoid arthritis Infection Biological therapy Antirheumatic agents |
| url | https://doi.org/10.1186/s13075-022-02820-y |
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