Op0015 incidence, Risk Factors and Validation of the Rabbit Score for Serious Infections in a Real Life Prospective Study of Patientswith Rheumatoid Arthritis: Data From 1.549 Patients

Abstract

BackgroundIdentification of the risk factors for the development of serious infections in patients with rheumatoid arthritis (RA) is critical for designing preventive measures and early treatment.ObjectivesTo identify risk factors for serious infections and to validate the RABBIT risk score in RA patients in daily clinical practice.MethodsMulticenter, prospective study of RA patients in Greece. Demographics, disease characteristics, treatments and co-morbidities were prospectively collected via a web-based platform at baseline and one year later. The observed incidence of serious infections was compared to the one estimated by the RABBIT score.Results1.549 RA patients were included (women: 78%, mean age: 63 years, mean disease duration: 10.4 years, RF and/or anti-CCP positive: 54%, mean DAS28: 3.4, mean HAQ: 0.5, bDMARD use: 46%, corticosteroid use: 36%). During follow-up, 38 serious infections were recorded (incidence: 2.3/100 patient-years). Patients who developed a serious infection had longer disease duration (14.2 vs. 10.3 years, p=0.02), higher HAQ at baseline (0.85 vs. 0.5, p=0.006), a history of previous serious infection (26% vs. 10%, p=0.002) and were more likely to have chronic lung disease (23% vs. 9%, p=0.008) or cardiovascular disease (23% vs. 11%, p=0.04). Disease duration (OR: 1.04, CI: 1.01-1.08, p=0.025), history of previous infection (OR: 3.3, CI: 1.3-8.1, p=0.01) and chronic lung disease (OR: 3.03, CI: 1.17-7.85, p=0.023) remained statistical significant in multivariate logistic regression analysis. bDMARD use was not associated with increased risk in uni-or multi-variate analysis. Data for RABBIT score calculation were available in 1.349 patients. Estimated incidence per 100 patient-years was divided in Q1-Q4 quartiles (25-50-75th percentiles: 0.94-1.35-2.15). Estimated and observed incidence rates were in Q1: 0.8 and 0.54, Q2: 1.14 and 0.79, Q3: 1.76 and 1.84 and Q4: 3.7 and 5.6, respectively (Hosmer Lemeshaw test, p=0.9).ConclusionIn this large, real life, prospective study of RA patients, the incidence of serious infections was 2.3/100 patient-years. Longer disease duration, history of previous serious infections and chronic lung disease were independently associated with the development of serious infections. RABBIT score predicted rather accurately the risk for serious infections in our cohort.References[1] Zink et al, Ann Rheum Dis. 2014 Sep; 73(9): 1673–1676.AcknowledgementSupported by grants from the Greek Rheumatology Society and Professional Association of Rheumatologists.Disclosure of InterestsKonstantinos Thomas: None declared, Argyro Lazarini: None declared, Evripidis Kaltsonoudis: None declared, Alexandros Drosos: None declared, Ioannis Papalopoulos: None declared, Prodromos Sidiropoulos: None declared, Panagiota Tsatsani: None declared, Sousana Gazi: None declared, Lina Pantazi: None declared, Kyriaki Boki: None declared, Pelagia Katsimbri: None declared, Dimitrios Boumpas: None declared, Kalliopi Fragkiadaki: None declared, Maria Tektonidou: None declared, Petros Sfikakis: None...

Patterns and factors associated with pneumococcal vaccination in a prospective cohort of 1,697 patients with rheumatoid arthritis

“…This was a multicenter, prospective study held by the RA Study Group of the Greek Rheumatology Society (ERE-EPERE) (16). Participating centers included academic and non-academic Rheumatology Clinics, National Health System outpatient clinics and private offices.…”

“…Inclusion criteria included age ≥ 18 years and RA diagnosis according to ACR/EULAR 10.3389/fmed.2022.1039464 2010 classification criteria (17). During Phase 1, a crosssectional evaluation of RA patients seen during a 9-month recruitment period was performed (June 2015-September 2016) (16). Patients were reevaluated 1 year (Phase 2) and 3 years (phase 3) later, as previously described (4,16,18).…”

“…During Phase 1, a crosssectional evaluation of RA patients seen during a 9-month recruitment period was performed (June 2015-September 2016) (16). Patients were reevaluated 1 year (Phase 2) and 3 years (phase 3) later, as previously described (4,16,18). Participating physicians were entering data either through a printed form or electronically via a specific web form through a designed portal 1 that consisted of the following sections: patient and disease characteristics, treatment patterns, and comorbidities.…”

“…Despite the fact that RA was recently described as a novel risk factor for pneumonia and pneumococcal disease, vaccination uptake is low in RA patients ranging from 20 to 54% in several European and US studies indicating a significant gap in the prevention of pneumococcal disease (15,16). There are limited data regarding the current trends in pneumococcal vaccination in RA patients.…”