scholarly journals Incidence and Risk Factors for Infections Requiring Hospitalization, Including Pneumocystis Pneumonia, in Japanese Patients with Rheumatoid Arthritis

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Atsushi Hashimoto ◽  
Shiori Suto ◽  
Kouichiro Horie ◽  
Hidefumi Fukuda ◽  
Shinichi Nogi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Respiratory Tract Infections ◽  
Multivariate Logistic Regression Analysis ◽  
Japanese Patients ◽  
Pneumocystis Pneumonia ◽  
Male Sex ◽  
The Individual ◽  
Tract Infections ◽  
Significant Factors

Objective. Rheumatoid arthritis (RA) may be complicated by different infections, but risk factors for these are not fully elucidated. Here, we assessed the incidence of and risk factors for infections requiring hospitalization (IRH) including pneumocystis pneumonia (PCP) in patients with RA. Methods. We retrospectively surveyed all RA patients treated at our hospital from 2009 to 2013, for whom data were available on demographic features, medications, comorbidities, and severity of RA. Multivariate logistic regression analysis was applied to calculate adjusted odds ratios (ORs) for factors associated with the occurrence of IRH. Results. In a total of 9210 patient-years (2688 patients), there were 373 IRH (3.7/100 patient-years). Respiratory tract infections were most frequent (n=154, and additionally 16 PCP), followed by urinary tract infections (n=50). Significant factors for PCP included higher age (≥70 years; OR 3.5), male sex (6.6), underlying lung disease (3.0), use of corticosteroids (4.8), and use of biologics (5.4). Use of methotrexate (5.7) was positively associated with PCP but negatively with total infections (0.7). Additionally, functional disorders and higher RA disease activity were also related to total infections. Conclusions. Risk factors for infection should be taken into account when deciding treatment for the individual RA patient.

scholarly journals Tuberculosis in biologic-naïve patients with rheumatoid arthritis - risk factors and tuberculosis characteristics

2021 ◽  
pp. jrheum.201251
Author(s):  
Johanna Karlsson Sundbaum ◽  
Elizabeth V. Arkema ◽  
Judith Bruchfeld ◽  
Jerker Jonsson ◽  
Johan Askling ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Population Based ◽  
Rheumatoid Arthritis Risk ◽  
Obstructive Pulmonary Disease ◽  
Quality Register ◽  
National Patient ◽  
Latent Tb ◽  
The Individual ◽  
Control Study

Objective To investigate risk factors and characteristics of active tuberculosis (TB) in biologics-naïve rheumatoid arthritis (RA) patients. Methods Population-based case-control study using the Swedish Rheumatology Quality Register, the National Patient Register and the Tuberculosis Register to identify RA cases with active TB and matched RA controls without TB 2001-2014. Clinical data were obtained from medical records. TB risk was estimated as adjusted (adj) odds ratios (OR) with 95% confidence intervals (CI) using univariate and multivariable logistic regression analyses. Results After validation of diagnoses, the study included 31 RA cases with TB, and 122 matched RA controls. All except three cases had reactivation of latent TB. Pulmonary TB dominated (84%). Ever use of methotrexate was not associated with increased TB risk (adj OR 0.8; 95% CI 0.3-2.0), whereas ever treatment with leflunomide (adj OR 6.0; 95% CI 1.5-24.6), azathioprine (adj OR 3.8; 95% CI 1.1-13.8) and prednisolone (adj OR 2.4 (95% CI 1.0-5.9) was. There were no significant differences of maximum dose of prednisolone, treatment duration with prednisolone before TB, or cumulative dose of prednisolone the year before TB diagnosis between cases and controls. Obstructive pulmonary disease was associated with an increased TB risk (adj OR 3.9; 95% CI 1.4-10.7). Conclusion Several RA-associated factors may contribute to the increased TB risk in biologics-naïve RA patients, making risk of TB activation difficult to predict in the individual patient. To further decrease TB in RA patients, the results suggest that screening for latent TB should also be considered in biologics-naïve patients.

Risk Factors and Viruses Associated With Hospitalization Due to Lower Respiratory Tract Infections in Canadian Inuit Children

2009 ◽  
Vol 28 (8) ◽  
pp. 697-701 ◽  
Author(s):  
Anna Banerji ◽  
David Greenberg ◽  
Laura Forsberg White ◽  
W Alexander Macdonald ◽  
Audrey Saxton ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Pre-rheumatoid arthritis

2020 ◽  
pp. 121-132
Author(s):  
Karim Raza ◽  
Catherine McGrath ◽  
Laurette van Boheemen ◽  
Dirkjan van Schaardenburg
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
At Risk ◽  
Genetic Risk ◽  
Inflammatory Arthritis ◽  
Primary Site ◽  
Individual Level ◽  
Mucosal Surfaces ◽  
Risk Patients ◽  
The Individual

The typical evolution of rheumatoid arthritis (RA) is that a person, with genetic risk factors, develops autoantibodies and subclinical inflammation under relevant environmental influences. There are indications that the primary site of the pathology is at mucosal surfaces (e.g. in the gums, lungs, and/or the gut), after which the disease translocates to the joints. Preclinical RA can be defined at the phase during which no clinically apparent features are present (i.e. no symptoms of inflammatory arthritis or clinically apparent joint swelling) but during which RA related biologic derangements such as the presence of autoantibodies are present. This chapter presents an overview of the risk factors, stages, and events occurring during the pre-RA phase. A better understanding of the factors involved will enable more accurate prediction of RA at the individual level and selection of high-risk individuals for inclusion in preventive studies. Several pharmacologic and non-pharmacologic studies aiming to prevent or delay the onset of RA in at-risk individuals are currently underway. It is hoped that such interventions in the pre-RA and indeed in the preclinical-RA phases will allow us to reduce the risk of RA and prevent RA developing in at least a proportion of at-risk patients.

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