Rheumatoid arthritis and risk of osteoarticular infection and death following Staphylococcus aureus bacteraemia : A nationwide cohort study
© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com..
OBJECTIVES: Osteoarticular infection (OAI) is a feared complication of Staphylococcus aureus bacteraemia (SAB) and is associated with poor outcomes. We aimed to explore risk of OAI and death following SAB in patients with and without rheumatoid arthritis (RA) and to identify risk factors for OAI in patients with RA.
METHODS: Danish nationwide cohort study of all patients with microbiologically verified first-time SAB between 2006-2018. We identified RA, SAB, comorbidities, and RA-related characteristics (e.g. orthopaedic implants, antirheumatic treatment) in national registries including the rheumatology registry DANBIO. We estimated cumulative incidence of OAI and death and adjusted hazard ratios (HRs, multivariate Cox regression).
RESULTS: We identified 18 274 patients with SAB (n = 367 with RA). The 90-day cumulative incidence of OAI was 23.1%(95%CI 18.8; 27.6) for patients with RA and 12.5%(12.1; 13.0) for patients without RA (non-RA) (HR 1.93(1.54; 2.41)). For RA patients with orthopaedic implants cumulative incidence was 29.4%(22.9; 36.2) (HR 1.75(1.08; 2.85), and for current users of tumor necrosis factor inhibitors (TNFi) it was 41.9%(27.0; 56.1) (HR 2.27(1.29; 3.98) compared with non-users). All-cause 90-day mortality following SAB was similar in RA (35.4%(30.6; 40.3)) and non-RA (33.9%(33.2; 34.5), HR 1.04(0.87; 1.24)).
CONCLUSION: Following SAB, almost one in four patients with RA contracted OAI corresponding to a doubled risk compared with non-RA. In RA, orthopaedic implants and current TNFi use were associated with approximately doubled OAI risk. One in three died within 90 days in both RA and non-RA. These findings encourage vigilance in RA patients with SAB to avoid treatment delay of OAI.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
Rheumatology (Oxford, England) - (2024) vom: 09. März |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Dieperink, Sabine S [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Revised 09.03.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1093/rheumatology/keae132 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM369499174 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM369499174 | ||
| 003 | DE-627 | ||
| 005 | 20240310232124.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240310s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1093/rheumatology/keae132 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1322.xml |
| 035 | |a (DE-627)NLM369499174 | ||
| 035 | |a (NLM)38460189 | ||
| 035 | |a (PII)keae132 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Dieperink, Sabine S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Rheumatoid arthritis and risk of osteoarticular infection and death following Staphylococcus aureus bacteraemia |b A nationwide cohort study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 09.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a OBJECTIVES: Osteoarticular infection (OAI) is a feared complication of Staphylococcus aureus bacteraemia (SAB) and is associated with poor outcomes. We aimed to explore risk of OAI and death following SAB in patients with and without rheumatoid arthritis (RA) and to identify risk factors for OAI in patients with RA | ||
| 520 | |a METHODS: Danish nationwide cohort study of all patients with microbiologically verified first-time SAB between 2006-2018. We identified RA, SAB, comorbidities, and RA-related characteristics (e.g. orthopaedic implants, antirheumatic treatment) in national registries including the rheumatology registry DANBIO. We estimated cumulative incidence of OAI and death and adjusted hazard ratios (HRs, multivariate Cox regression) | ||
| 520 | |a RESULTS: We identified 18 274 patients with SAB (n = 367 with RA). The 90-day cumulative incidence of OAI was 23.1%(95%CI 18.8; 27.6) for patients with RA and 12.5%(12.1; 13.0) for patients without RA (non-RA) (HR 1.93(1.54; 2.41)). For RA patients with orthopaedic implants cumulative incidence was 29.4%(22.9; 36.2) (HR 1.75(1.08; 2.85), and for current users of tumor necrosis factor inhibitors (TNFi) it was 41.9%(27.0; 56.1) (HR 2.27(1.29; 3.98) compared with non-users). All-cause 90-day mortality following SAB was similar in RA (35.4%(30.6; 40.3)) and non-RA (33.9%(33.2; 34.5), HR 1.04(0.87; 1.24)) | ||
| 520 | |a CONCLUSION: Following SAB, almost one in four patients with RA contracted OAI corresponding to a doubled risk compared with non-RA. In RA, orthopaedic implants and current TNFi use were associated with approximately doubled OAI risk. One in three died within 90 days in both RA and non-RA. These findings encourage vigilance in RA patients with SAB to avoid treatment delay of OAI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Staphylococcus aureus | |
| 650 | 4 | |a Biologic disease-modifying antirheumatic drugs | |
| 650 | 4 | |a Epidemiology | |
| 650 | 4 | |a Glucocorticoids | |
| 650 | 4 | |a Infection | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Prosthetic joint infection | |
| 650 | 4 | |a Rheumatoid arthritis | |
| 650 | 4 | |a Septic arthritis | |
| 650 | 4 | |a Time-to-event study | |
| 700 | 1 | |a Nørgaard, Mette |e verfasserin |4 aut | |
| 700 | 1 | |a Mehnert, Frank |e verfasserin |4 aut | |
| 700 | 1 | |a Oestergaard, Louise B |e verfasserin |4 aut | |
| 700 | 1 | |a Benfield, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Torp-Pedersen, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Petersen, Andreas |e verfasserin |4 aut | |
| 700 | 1 | |a Glintborg, Bente |e verfasserin |4 aut | |
| 700 | 1 | |a Hetland, Merete L |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Rheumatology (Oxford, England) |d 1999 |g (2024) vom: 09. März |w (DE-627)NLM102581908 |x 1462-0332 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:09 |g month:03 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/rheumatology/keae132 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 09 |c 03 | ||