ArticleJournal of clinical medicine2022
Risk of Severe Infection among Rheumatoid Arthritis Patients on Biological DMARDs: A Population-Based Cohort Study.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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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.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Infectious Risks Associated with Biologic Therapies in Autoimmune, Rheumatologic and Dermatologic Diseases: A Narrative Review.Microorganisms · 2026Review
- Risk factors of serious infections in patients with large-vessel vasculitis after the approval of tocilizumab in 2017: a retrospective nested case-control study using the Japanese health insurance database.Arthritis research & therapy · 2026Observational
- Decreased in-hospital mortality in shock patients with rheumatoid arthritis compared to those without: a retrospective analysis of a critical care database.Clinical rheumatology · 2025Observational
- Lymphadenopathy and synovial hyperplasia are associated with sepsis risk in an experimental model of rheumatoid arthritis.Frontiers in immunology · 2025Article
- Disproportionality Analysis and Characterisation of Medication Errors in EudraVigilance: Exploring Findings on Sexes and Age Groups.Drug safety · 2025Article
- The Incidence, Aetiology and Clinical Course of Serious Infections Complicating Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drug Therapy in Patients with Rheumatoid Arthritis in Tropical Australia.Pathogens (Basel, Switzerland) · 2024Article
- Effectiveness of Different Rituximab Doses Combined with Leflunomide in the Treatment or Retreatment of Rheumatoid Arthritis: Part 2 of a Randomized, Placebo-Controlled, Investigator-Initiated Clinical Trial (AMARA).Journal of clinical medicine · 2022Article
- Reestablish immune tolerance in rheumatoid arthritis.Frontiers in immunology · 2022Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
Biological disease-modifying anti-rheumatic drugs (bDMARDs) are widely used for the management of rheumatoid arthritis, although their benefits are counterweight by an increased risk of infections. In the present study, we used administrative data to compare the risk of severe infections among different classes of bDMARDs. A retrospective cohort study was conducted using Administrative Health Databases of the Piedmont Region, Italy. Relevant data were obtained from: (1) the inhabitants registry, (2) hospital discharge records, and (3) the co-payment exemption registry and (4) drug claims registry. Fine and Gray competing risk models were fitted to evaluate the association between the use of different types of bDMARDs and occurrence of severe infection accounting for treatment interruption as competing risk. A total of 1780 new users of bDMARDs were identified. Among them, 50 hospitalizations for infection occurred during the study period. The use of Tocilizumab was associated with an increased risk of infection, compared to tumor necrosis factor (TNF) inhibitor drugs (sub-distribution hazard ratios-sHR: 2.510; 95% CI: 1.279-4.926), whereas no difference in the risk of severe infection was found for abatacept (sHR: 0.584; 95% CI: 0.234-1.457). bDMARDs treatment is generally safe in clinical practice with slight but important differences among classes. The increased risk of infection associated with tocilizumab use should be taken into account when balancing the risk and benefits of starting a treatment with this drug.
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