Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study

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

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Article number131
JournalArthritis Research and Therapy
Volume24
Issue number1
DOIs
Publication statusPublished - Dec 2022

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Fingerprint

Dive into the research topics of 'Clinical course of patients with rheumatoid arthritis who continue or discontinue biologic therapy after hospitalization for infection: a retrospective observational study'. Together they form a unique fingerprint.

Cite this