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首页> 外文期刊>Rheumatology >Predictors for the 5-year risk of serious infections in patients with rheumatoid arthritis treated with anti-tumour necrosis factor therapy: A cohort study in the dutch rheumatoid arthritis monitoring (DREAM) registry
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Predictors for the 5-year risk of serious infections in patients with rheumatoid arthritis treated with anti-tumour necrosis factor therapy: A cohort study in the dutch rheumatoid arthritis monitoring (DREAM) registry

机译：抗肿瘤坏死因子治疗的类风湿关节炎患者5年严重感染风险的预测指标：荷兰类风湿关节炎监测（DREAM）注册表中的一项队列研究

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Objective: The use of TNF inhibitors leads to an increased risk of serious infections in RA. Predicting this risk would facilitate the prevention of serious infections. The objective of this study was to identify which factors are predictive of the increased risk of serious infections in RA patients treated with TNF inhibiting therapy. Methods: Data from the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry of 2044 patients with RA were used for the analyses. Data were censored at stopping TNF inhibitors or end of observation time up to 5 years. Univariate and multivariate analysis of baseline variables was performed using Cox regression with time to the first serious infection as dependent variable. Results: During a follow-up time of 5 years, 128 of 2044 (6.3%) patients developed a first serious infection with a total of 141 serious infections. The incidence rate in the first year after start of TNF inhibiting therapy was 4.57 first serious infections per 100 patient-years and 2.91 per 100 patient-years over 5 years. Age, corticosteroid use, visual analogue scale (VAS) pain, HAQ, tender joint count 28 joints (TJC28) and the presence of comorbidities were significant predictors for developing a serious infection during TNF inhibiting therapy in the multivariate model. Conclusion: Age, corticosteroid use, VAS pain, HAQ, TJC28 and the presence of comorbidities all at baseline were significant predictors for developing a serious infection during TNF inhibiting therapy in RA patients.
机译：目的：TNF抑制剂的使用导致RA中严重感染的风险增加。预测这种风险将有助于预防严重感染。这项研究的目的是确定哪些因素可以预示接受TNF抑制疗法的RA患者发生严重感染的风险增加。方法：使用来自2044名RA患者的荷兰类风湿关节炎监测（DREAM）注册表中的数据进行分析。在停止TNF抑制剂或结束长达5年的观察时间时对数据进行检查。使用Cox回归进行基线变量的单变量和多变量分析，并以首次严重感染的时间作为因变量。结果：在5年的随访时间内，2044例患者中有128例（6.3％）发生了首次严重感染，总共141例严重感染。 TNF抑制治疗开始后第一年的发病率是每100个病人年4.57例首次严重感染，五年内每100个病人年2.91例。在多变量模型中，年龄，皮质类固醇的使用，视觉模拟量表（VAS）疼痛，HAQ，28个关节的嫩关节计数（TJC28）和合并症的存在是在TNF抑制治疗期间发生严重感染的重要预测因素。结论：基线时的年龄，皮质类固醇使用，VAS疼痛，HAQ，TJC28以及合并症均是在RA抑制TNF治疗期间严重感染的重要预测因素。

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