Evidence map›Paper›PMID 24608404›Full record

ArticleAnnals of the rheumatic diseases2015

Risk of hospitalised infection in rheumatoid arthritis patients receiving biologics following a previous infection while on treatment with anti-TNF therapy.

Huifeng Yun, Fenglong Xie, Elizabeth Delzell, Lang Chen, Emily B Levitan, James D Lewis, Kenneth G Saag, Timothy Beukelman, Kevin Winthrop, John W Baddley and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of the rheumatic diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 6 pooled it
6.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 6 syntheses or guidelines pooled it, 92 citations in OpenAlex.

  1. Pooled it
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  5. Guideline
  6. Pooled it
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  13. The Emerging Safety Profile of JAK Inhibitors in Rheumatic Diseases.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2023
    Review
  14. Review
  15. Article
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  17. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Huifeng YunDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Fenglong XieDivision of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Elizabeth DelzellDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Lang ChenDivision of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Emily B LevitanDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
James D LewisDivision of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Kenneth G SaagDivision of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Timothy BeukelmanDivision of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Kevin WinthropDivisions of Infectious Diseases, Public Health, and Preventive Medicine, Oregon Health & Science University, Portland, Oregon, USA.
John W BaddleyDivision of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Jeffrey R CurtisDepartment of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
University of Alabama at Birmingham · USOregon Health & Science University · USUniversity of Pennsylvania · US

Funding

UAB K12 in Patient Centered Outcomes ResearchK12HS023009 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2014 to 2018
$4.0M
Longitudinal Comparative Effectiveness & Safety of Biologics in AutoimmunityR01HS018517 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CURTIS, JEFFREY R. · 2009 to 2013
$2.2M
Mid-Career Investigator Award (for Kenneth G. Saag, MD, MSc)K24AR052361 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2005 to 2014
$1.7M
UAB K12 in Patient Centered Outcomes ResearchK12HS021694 · AHRQ · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI SAAG, KENNETH G · 2012 to 2013
$900k
Ethnic Differences in the Risk of Fracture and Vascular DiseaseK23AR053351 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CURTIS, JEFFREY R. · 2007 to 2011
$755k
AHRQ HHS 1 K12 HS021694AHRQ HHS K12 HS021694AHRQ HHS K12 HS023009AHRQ HHS R01 HS018517NIAMS NIH HHS K23 AR053351NIAMS NIH HHS K24 AR052361
6 · The paper itself

Abstract

backgroundThe risk of subsequent infections in rheumatoid arthritis (RA) patients who receive biologic therapy after a serious infection is unclear.

objectiveTo compare the subsequent risk of hospitalised infections associated with specific biologic agents among RA patients previously hospitalised for infection while receiving anti-tumour necrosis factor (anti-TNF) therapy.

methodsUsing 2006-2010 Medicare data for 100% of beneficiaries with RA enrolled in Medicare, we identified patients hospitalised with an infection while on anti-TNF agents. Follow-up began 61 days after hospital discharge and ended at the earliest of: next infection, loss of Medicare coverage or 18 months after start of follow-up. We calculated the incidence rate of subsequent hospitalised infection for each biologic and used Cox regression to control for potential confounders.

results10 794 eligible hospitalised infections among 10183 unique RA patients who contributed at least 1 day of biologic exposure during follow-up. We identified 7807 person-years of exposure to selected biologics--333 abatacept, 133 rituximab and 7341 anti-TNFs (1797 etanercept, 1405 adalimumab, 4139 infliximab)--and 2666 associated infections. Mean age across biologic exposure cohorts was 64-69 years. The crude incidence rate of subsequent hospitalised infection ranged from 27.1 to 34.6 per 100 person-years. After multivariable adjustment, abatacept (HR: 0.80, 95% CI 0.64 to 0.99) and etanercept (HR: 0.83, 95% CI 0.72 to 0.96) users had significantly lower risks of subsequent infection compared to infliximab users.

conclusionsAmong RA patients who experienced a hospitalised infection while on anti-TNF therapy, abatacept and etanercept were associated with the lowest risk of subsequent infection compared to other biologic therapies.

Indexed as

AbataceptAdalimumabAgedAged, 80 and overAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntibodies, Monoclonal, Murine-DerivedAntirheumatic AgentsArthritis, RheumatoidCohort StudiesEtanerceptFemaleHospitalizationHumansImmunoconjugatesImmunoglobulin GAbataceptAdalimumabAntibodies, MonoclonalAntibodies, Monoclonal, HumanizedAntibodies, Monoclonal, Murine-DerivedAntirheumatic AgentsEtanerceptImmunoconjugatesImmunoglobulin GInfliximabReceptors, Tumor Necrosis FactorRituximabTumor Necrosis Factor-alphaabataceptanti-TNF therapybiologicsinfectionrheumatoid arthritisrituximab

Identifiers

PMID24608404
PMCPMC4441344
OpenAlexW2152950999

What OpenQuestion holds

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LicenceTDM
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.