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Long-term use of biologic agents does not increase the risk of serious infections in elderly patients with rheumatoid arthritis.

To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00296-016-3631-z Byline: Hirotoshi Kawashima (1), Shin-ichiro Kagami (1), Daisuke Kashiwakuma (1), Kentaro Takahashi (1), Masaya Yokota (1), Shunsuke Furuta (1), Itsuo... Full description

Journal Title: Rheumatology international March 2017, Vol.37(3), pp.369-376
Main Author: Kawashima, Hirotoshi
Other Authors: Kagami, Shin-Ichiro , Kashiwakuma, Daisuke , Takahashi, Kentaro , Yokota, Masaya , Furuta, Shunsuke , Iwamoto, Itsuo
Format: Electronic Article Electronic Article
Language: English
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ID: E-ISSN: 1437-160X ; DOI: 10.1007/s00296-016-3631-z
Link: http://search.proquest.com/docview/1851295480/?pq-origsite=primo
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title: Long-term use of biologic agents does not increase the risk of serious infections in elderly patients with rheumatoid arthritis.
format: Article
creator:
  • Kawashima, Hirotoshi
  • Kagami, Shin-Ichiro
  • Kashiwakuma, Daisuke
  • Takahashi, Kentaro
  • Yokota, Masaya
  • Furuta, Shunsuke
  • Iwamoto, Itsuo
subjects:
  • Age Factors–Therapeutic Use
  • Aged–Drug Therapy
  • Antirheumatic Agents–Adverse Effects
  • Arthritis, Rheumatoid–Therapeutic Use
  • Biological Factors–Administration & Dosage
  • Case-Control Studies–Adverse Effects
  • Chi-Square Distribution–Chemically Induced
  • Female–Epidemiology
  • Glucocorticoids–Therapeutic Use
  • Hospitalization–Administration & Dosage
  • Humans–Adverse Effects
  • Incidence–Adverse Effects
  • Infection–Adverse Effects
  • Kaplan-Meier Estimate–Adverse Effects
  • Logistic Models–Adverse Effects
  • Male–Adverse Effects
  • Methotrexate–Adverse Effects
  • Prednisolone–Adverse Effects
  • Retrospective Studies–Adverse Effects
  • Risk–Adverse Effects
  • Statistics, Nonparametric–Adverse Effects
  • Antirheumatic Agents
  • Biological Factors
  • Glucocorticoids
  • Prednisolone
  • Methotrexate
  • Aging
  • Biologic Agents
  • Glucocorticoid
  • Infection
  • Rheumatoid Arthritis
ispartof: Rheumatology international, March 2017, Vol.37(3), pp.369-376
description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00296-016-3631-z Byline: Hirotoshi Kawashima (1), Shin-ichiro Kagami (1), Daisuke Kashiwakuma (1), Kentaro Takahashi (1), Masaya Yokota (1), Shunsuke Furuta (1), Itsuo Iwamoto (1) Keywords: Rheumatoid arthritis; Biologic agents; Infection; Aging; Glucocorticoid Abstract: This study aimed to determine whether the long-term use of biologic agents increases serious infections in elderly patients with rheumatoid arthritis (RA) and to determine the risk factors of serious infections in biologics-treated elderly RA patients. We retrospectively analyzed the incidence rate of serious infections that required hospitalization between biologics-treated and non-biologic disease-modifying antirheumatic drug (DMARD)-treated elderly RA patients (aged over 65 years). We examined the risk factors for serious infections in biologics-treated elderly RA patients. We found that, during a 3-year observation period, the incidence rate of serious infections was not significantly different between biologics-treated and non-biologic DMARD-treated elderly RA patients [8.0 (95% CI 4.7--13.5) and 6.3 (95% CI 4.1--9.5) events per 100 person-years of follow-up, respectively, P = 0.78]. The time to the first serious infection did not significantly differ between the two groups by the analysis of the Kaplan--Meier curves, either (P = 0.46). We then found that prednisolone doses alone were significantly associated with serious infections in biologics-treated elderly RA patients. Furthermore, we found that prednisolone at 1--4 mg/day was associated with serious infections in biologics-treated patients, but not non-biologic DMARD-treated patients. On the other hand, prednisolone at greater than 5 mg/day was associated with serious infections in both biologics-treated and non-biologics-treated patients. We show that there is not a significant difference between the incidence of serious infections between biologics group and non-biologics group in elderly RA patients (as.65 years) and that even very low-dose glucocorticoid use (prednisolone 1--4 mg/day) is a risk factor for serious infections in biologics-treated elderly RA patients. Author Affiliation: (1) Research Center for Allergy and Clinical Immunology, Asahi General Hospital, I-1326, Asahi City, Chiba, 289-2511, Japan Article History: Registration Date: 07/12/2016 Received Date: 24/06/2016 Accepted Date: 0
language: eng
source:
identifier: E-ISSN: 1437-160X ; DOI: 10.1007/s00296-016-3631-z
fulltext: fulltext
issn:
  • 1437160X
  • 1437-160X
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identifierE-ISSN: 1437-160X ; DOI: 10.1007/s00296-016-3631-z
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descriptionTo access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00296-016-3631-z Byline: Hirotoshi Kawashima (1), Shin-ichiro Kagami (1), Daisuke Kashiwakuma (1), Kentaro Takahashi (1), Masaya Yokota (1), Shunsuke Furuta (1), Itsuo Iwamoto (1) Keywords: Rheumatoid arthritis; Biologic agents; Infection; Aging; Glucocorticoid Abstract: This study aimed to determine whether the long-term use of biologic agents increases serious infections in elderly patients with rheumatoid arthritis (RA) and to determine the risk factors of serious infections in biologics-treated elderly RA patients. We retrospectively analyzed the incidence rate of serious infections that required hospitalization between biologics-treated and non-biologic disease-modifying antirheumatic drug (DMARD)-treated elderly RA patients (aged over 65 years). We examined the risk factors for serious infections in biologics-treated elderly RA patients. We found that, during a 3-year observation period, the incidence rate of serious infections was not significantly different between biologics-treated and non-biologic DMARD-treated elderly RA patients [8.0 (95% CI 4.7--13.5) and 6.3 (95% CI 4.1--9.5) events per 100 person-years of follow-up, respectively, P = 0.78]. The time to the first serious infection did not significantly differ between the two groups by the analysis of the Kaplan--Meier curves, either (P = 0.46). We then found that prednisolone doses alone were significantly associated with serious infections in biologics-treated elderly RA patients. Furthermore, we found that prednisolone at 1--4 mg/day was associated with serious infections in biologics-treated patients, but not non-biologic DMARD-treated patients. On the other hand, prednisolone at greater than 5 mg/day was associated with serious infections in both biologics-treated and non-biologics-treated patients. We show that there is not a significant difference between the incidence of serious infections between biologics group and non-biologics group in elderly RA patients (as.65 years) and that even very low-dose glucocorticoid use (prednisolone 1--4 mg/day) is a risk factor for serious infections in biologics-treated elderly RA patients. Author Affiliation: (1) Research Center for Allergy and Clinical Immunology, Asahi General Hospital, I-1326, Asahi City, Chiba, 289-2511, Japan Article History: Registration Date: 07/12/2016 Received Date: 24/06/2016 Accepted Date: 07/12/2016 Online Date: 20/12/2016
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