Evidence map›Paper›PMID 34905480›Full record

ArticleClinical and experimental rheumatology2022

Giant cell arteritis treatment patterns and rates of serious infections.

Sara K Tedeschi, Yinzhu Jin, Seanna Vine, Hemin Lee, Attila Pethoe-Schramm, Vincent Yau, Seoyoung C Kim

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

Article in Clinical and experimental rheumatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.8field-weighted citation impact, top 14% 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

9 citing papers in PubMed, 14 citations in OpenAlex.

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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

7 authors at 3 institutions in 2 countries.

Sara K TedeschiDivision of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. stedeschi1@bwh.harvard.edu.
Yinzhu JinDivision of Pharmacoepidemiology & Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Seanna VineDivision of Pharmacoepidemiology & Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Hemin LeeDivision of Pharmacoepidemiology & Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Attila Pethoe-SchrammF. Hoffmann-La Roche Ltd. Basel, Switzerland.
Vincent YauGenentech, South San Francisco, CA, USA.
Seoyoung C KimDivision of Rheumatology, Inflammation and Immunity and Division of Pharmacoepidemiology & Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Brigham and Women's Hospital · USHarvard University · USRoche (Switzerland) · CH

Funding

Studying pseudogout using naturallanguage processing and novelimaging approachesK23AR075070 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI TEDESCHI, SARA K. · 2019 to 2023
$937k
NIAMS NIH HHS K23 AR075070
6 · The paper itself

Abstract

objectivesGiant cell arteritis (GCA) afflicts older adults who may have age- and comorbidity-related risks for infection and is treated with immunosuppressants that increase risk of infection. We examined GCA treatment patterns and rates of serious infections in two real-world cohorts in the U.S.

methodsWe identified two GCA cohorts using two U.S. health insurance databases, Medicare (public, 2007-2017) and MarketScan (commercial, 2015-2019), by applying a validated claims-based algorithm with positive predictive value 79.0% for GCA. We required age ≥50 years and assessed baseline comorbidities, dispensing of immunosuppressants and prophylactic antibiotics, and vaccine administration. We calculated incidence rates (IR) of serious infections, defined as bacterial or viral infections requiring hospitalisation based on primary inpatient diagnosis code. Multivariable Cox proportional hazards models estimated hazard ratios for risk of serious infection for prespecified covariates.

resultsThe Medicare cohort included 734 patients, 28% male, mean age 77.1; the MarketScan cohort included 1022 patients, 30% male, mean age 68.4. More than 85% used prednisone ≥60mg daily at index date and <10% used tocilizumab. Serious infections developed in 27.9% of Medicare and 7.2% of MarketScan patients: IR per 100 person-years = 10.7 (95% CI 9.3, 12.2) in Medicare and 6.3 (95% CI 5.0, 7.9) in MarketScan. Older age and higher frailty score were significantly associated with increased risk for serious infection.

conclusionsIn these two U.S. GCA cohorts, high-dose glucocorticoids were the most common initial treatment, and over 25% of Medicare and 7% of MarketScan patients developed serious infection during follow-up. Older age and higher frailty score were associated with higher risk of serious infections, though maximum daily prednisone dose was not. Pneumocystis jiroveci pneumonia was rare in two GCA cohorts despite infrequent use of prophylactic antibiotics.

Indexed as

FrailtyGiant Cell ArteritisAgedAnti-Bacterial AgentsFemaleHumansImmunosuppressive AgentsMaleMedicareMiddle AgedPrednisoneUnited StatesAnti-Bacterial AgentsImmunosuppressive AgentsPrednisone

Identifiers

PMID34905480
PMCPMC10475312
OpenAlexW4200628662

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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.