AB0274 The association between repeatedly infection and disease outcome in patients with rheumatoid arthritis
Authors: R Zhang, J He, C Li, J Li, J Chen, Y Jin, Y Gan, Z Li
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Some publications shows some therapies in rheumatoid arthritis (RA) could cause infections and it also can react the disease prognosis. But there was no report about the relationship between the repeated infections during the disease duration and its outcome. <h3>Objectives</h3> Our study was to evaluate the association between the history of repeated infectious agents that occurred more than three times during the duration of RA and the current disease status of RA, such as disease activity and physical disability. <h3>Methods</h3> 688 pure RA patients were selected from December 2015 to June 2016 in Peking People9s hospital and divided into two groups according to their current disease status. Clinical data were collected including DAS28, HAQ, disease duration and therapies. Infectious agents occurred repeatedly during the duration were identified as history repeated infectious agents. T test, ANOVA, chi-squared test and multivariate analysis of covariance were used for analyzing the association between the infections and disease outcome. <h3>Results</h3> 688 RA patients were divided into two groups based on whether their DAS28 reached 3.2 (active or inactive). The HAQ score and the incidence of airway infection has a significant difference among these two groups (P=0.000; P=0.002). Logistic regression analysis shows that smoking, airway infection and age were the risk factor for RA activite (OR=4.844, 95% CI (0.193,1.001); OR=1.326, 95% CI (0.655,2.687); OR=1.013, 95% CI (0.989,1.037)), and the disease duration and the therapy were also effect the disease outcome (OR=0.650;OR=1.560). Than we divided these patients into four groups based on their infectious site such as airway, urinary, intestinal and no-infection. After adjusting for the disease duration, only airway infection incidence has statistically significantly different (P=0.000). DAS 28 has statistical different only among the groups whether they have airway infectious agents after adjusting the smoking and therapy (P=0.002; P=0.002). Compared with infection free group, patients with airway infection has a higher DAS28 because they have more swollen or painful joints, while patients with urinary infection perform a higher scores because they have a high level of ESR. <h3>Conclusions</h3> The repeated infectious agents during the disease duration might lead to poor outcome. We should pay more attention to those patients who have repeatedly infectious agents during their disease duration in order to improve their prognosis. <h3>References</h3> Sokolove J, Wagner CA, Lahey LJ, et al. Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis: a cross-sectional analysis of US veterans. Rheumatology (Oxford). 2016;55(11):1969–77. Sokolove J, Wagner CA, Lahey LJ, et al. Increased inflammation and disease activity among current cigarette smokers with rheumatoid arthritis: a cross-sectional analysis of US veterans. Rheumatology (Oxford). 2016;55(11):1969–77. Iguchi-Hashimoto M, Hashimoto M, Fujii T, et al. The association between serious infection and disease outcome in patients with rheumatoid arthritis. Clin Rheumatol. 2016;35(1):213–8. <h3>Disclosure of Interest</h3> None declared