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Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study

BACKGROUND: Patients with rheumatoid arthritis (RA) are known to be at increased risk of infection, particularly if they are taking drugs with immunomodulatory effects. There is a need for more information on the risk of influenza in patients with RA. METHODS: A retrospective cohort study was carrie...

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Autores principales: Blumentals, William A, Arreglado, Anna, Napalkov, Pavel, Toovey, Stephen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495205/
https://www.ncbi.nlm.nih.gov/pubmed/22925480
http://dx.doi.org/10.1186/1471-2474-13-158
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author Blumentals, William A
Arreglado, Anna
Napalkov, Pavel
Toovey, Stephen
author_facet Blumentals, William A
Arreglado, Anna
Napalkov, Pavel
Toovey, Stephen
author_sort Blumentals, William A
collection PubMed
description BACKGROUND: Patients with rheumatoid arthritis (RA) are known to be at increased risk of infection, particularly if they are taking drugs with immunomodulatory effects. There is a need for more information on the risk of influenza in patients with RA. METHODS: A retrospective cohort study was carried out using data gathered from a large US commercial health insurance database (Thomson Reuters Medstat MarketScan) from 1 January 2000 to 31 December 2007. Patients were ≥18 years of age, with at least two RA claims diagnoses. The database was scanned for incidence of seasonal influenza and its complications on or up to 30 days after an influenza diagnosis in RA patients and matched controls. Other factors accounted for included medical conditions, use of disease-modifying anti-rheumatic drugs (DMARDs), use of biological agents, influenza vaccination and high- or low-dose corticosteroids. Incidence rate ratios (IRRs) were calculated for influenza and its complications in patients with RA. RESULTS: 46,030 patients with RA and a matching number of controls had a median age of 57 years. The incidence of influenza was higher in RA patients than in controls (409.33 vs 306.12 cases per 100,000 patient-years), and there was a 2.75-fold increase in incidence of complications in RA. Presence or absence of DMARDs or biologics had no significant effect. The adjusted IRR of influenza was statistically significant in patients aged 60–69 years, and especially among men. A significantly increased rate of influenza complications was observed in women and in both genders combined (but not in men only) when all age groups were combined. In general, the risk of influenza complications was similar in RA patients not receiving DMARDs or biologics to that in all RA patients. Pneumonia rates were significantly higher in women with RA. Rates of stroke/myocardial infarction (MI) were higher in men, although statistical significance was borderline. CONCLUSIONS: RA is associated with increased incidence of seasonal influenza and its complications. Gender- and age-specific subgroup data indicate that women generally have a greater rate of complications than men, but that men primarily have an increased rate of stroke and MI complications. Concomitant DMARD or biological use appears not to significantly affect the rate of influenza or its complications.
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spelling pubmed-34952052012-11-12 Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study Blumentals, William A Arreglado, Anna Napalkov, Pavel Toovey, Stephen BMC Musculoskelet Disord Research Article BACKGROUND: Patients with rheumatoid arthritis (RA) are known to be at increased risk of infection, particularly if they are taking drugs with immunomodulatory effects. There is a need for more information on the risk of influenza in patients with RA. METHODS: A retrospective cohort study was carried out using data gathered from a large US commercial health insurance database (Thomson Reuters Medstat MarketScan) from 1 January 2000 to 31 December 2007. Patients were ≥18 years of age, with at least two RA claims diagnoses. The database was scanned for incidence of seasonal influenza and its complications on or up to 30 days after an influenza diagnosis in RA patients and matched controls. Other factors accounted for included medical conditions, use of disease-modifying anti-rheumatic drugs (DMARDs), use of biological agents, influenza vaccination and high- or low-dose corticosteroids. Incidence rate ratios (IRRs) were calculated for influenza and its complications in patients with RA. RESULTS: 46,030 patients with RA and a matching number of controls had a median age of 57 years. The incidence of influenza was higher in RA patients than in controls (409.33 vs 306.12 cases per 100,000 patient-years), and there was a 2.75-fold increase in incidence of complications in RA. Presence or absence of DMARDs or biologics had no significant effect. The adjusted IRR of influenza was statistically significant in patients aged 60–69 years, and especially among men. A significantly increased rate of influenza complications was observed in women and in both genders combined (but not in men only) when all age groups were combined. In general, the risk of influenza complications was similar in RA patients not receiving DMARDs or biologics to that in all RA patients. Pneumonia rates were significantly higher in women with RA. Rates of stroke/myocardial infarction (MI) were higher in men, although statistical significance was borderline. CONCLUSIONS: RA is associated with increased incidence of seasonal influenza and its complications. Gender- and age-specific subgroup data indicate that women generally have a greater rate of complications than men, but that men primarily have an increased rate of stroke and MI complications. Concomitant DMARD or biological use appears not to significantly affect the rate of influenza or its complications. BioMed Central 2012-08-27 /pmc/articles/PMC3495205/ /pubmed/22925480 http://dx.doi.org/10.1186/1471-2474-13-158 Text en Copyright ©2012 Blumentals et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Blumentals, William A
Arreglado, Anna
Napalkov, Pavel
Toovey, Stephen
Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study
title Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study
title_full Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study
title_fullStr Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study
title_full_unstemmed Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study
title_short Rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study
title_sort rheumatoid arthritis and the incidence of influenza and influenza-related complications: a retrospective cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495205/
https://www.ncbi.nlm.nih.gov/pubmed/22925480
http://dx.doi.org/10.1186/1471-2474-13-158
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