OP0015 INCIDENCE, RISK FACTORS AND VALIDATION OF THE RABBIT SCORE FOR SERIOUS INFECTIONS IN A REAL LIFE PROSPECTIVE STUDY OF PATIENTSWITH RHEUMATOID ARTHRITIS: DATA FROM 1.549 PATIENTS
Authors: Konstantinos Thomas, Argyro Lazarini, Evripidis Kaltsonoudis, Alexandros Drosos, Ioannis Papalopoulos, Prodromos Sidiropoulos, Panagiota Tsatsani, Sousana Gazi, Lina Pantazi, Kyriaki Boki, Pelagia Katsimbri, Dimitrios Boumpas, Kalliopi Fragkiadaki, Maria Tektonidou, Petros Sfikakis, Konstantina Karagianni, Lazaros Sakkas, Gerasimos Evangelatos, Alexios Iliopoulos, Eleftheria Grika, Panayiotis Vlachoyiannopoulos, Theodoros Dimitroulas, Alexandros Garyfallos, Konstantinos Melissaropoulos, Panagiotis Georgiou, Maria Areti, Constantinos Georganas, Periklis Vounotrypidis, Georgios Georgiopoulos, George D. Kitas, Dimitrios Vassilopoulos
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Identification of the risk factors for the development of serious infections in patients with rheumatoid arthritis (RA) is critical for designing preventive measures and early treatment. <h3>Objectives</h3> To identify risk factors for serious infections and to validate the RABBIT risk score in RA patients in daily clinical practice. <h3>Methods</h3> Multicenter, prospective study of RA patients in Greece. Demographics, disease characteristics, treatments and co-morbidities were prospectively collected via a web-based platform at baseline and one year later. The observed incidence of serious infections was compared to the one estimated by the RABBIT score. <h3>Results</h3> 1.549 RA patients were included (women: 78%, mean age: 63 years, mean disease duration: 10.4 years, RF and/or anti-CCP positive: 54%, mean DAS28: 3.4, mean HAQ: 0.5, bDMARD use: 46%, corticosteroid use: 36%). During follow-up, 38 serious infections were recorded (incidence: 2.3/100 patient-years). Patients who developed a serious infection had longer disease duration (14.2 vs. 10.3 years, p=0.02), higher HAQ at baseline (0.85 vs. 0.5, p=0.006), a history of previous serious infection (26% vs. 10%, p=0.002) and were more likely to have chronic lung disease (23% vs. 9%, p=0.008) or cardiovascular disease (23% vs. 11%, p=0.04). Disease duration (OR: 1.04, CI: 1.01-1.08, p=0.025), history of previous infection (OR: 3.3, CI: 1.3-8.1, p=0.01) and chronic lung disease (OR: 3.03, CI: 1.17-7.85, p=0.023) remained statistical significant in multivariate logistic regression analysis. bDMARD use was not associated with increased risk in uni-or multi-variate analysis. Data for RABBIT score calculation were available in 1.349 patients. Estimated incidence per 100 patient-years was divided in Q1-Q4 quartiles (25-50-75th percentiles: 0.94-1.35-2.15). Estimated and observed incidence rates were in Q1: 0.8 and 0.54, Q2: 1.14 and 0.79, Q3: 1.76 and 1.84 and Q4: 3.7 and 5.6, respectively (Hosmer Lemeshaw test, p=0.9). <h3>Conclusion</h3> In this large, real life, prospective study of RA patients, the incidence of serious infections was 2.3/100 patient-years. Longer disease duration, history of previous serious infections and chronic lung disease were independently associated with the development of serious infections. RABBIT score predicted rather accurately the risk for serious infections in our cohort. <h3>References</h3> [1] Zink et al, Ann Rheum Dis. 2014 Sep; 73(9): 1673–1676. <h3>Acknowledgement</h3> Supported by grants from the Greek Rheumatology Society and Professional Association of Rheumatologists. <h3>Disclosure of Interests</h3> Konstantinos Thomas: None declared, Argyro Lazarini: None declared, Evripidis Kaltsonoudis: None declared, Alexandros Drosos: None declared, Ioannis Papalopoulos: None declared, Prodromos Sidiropoulos: None declared, Panagiota Tsatsani: None declared, Sousana Gazi: None declared, Lina Pantazi: None declared, Kyriaki Boki: None declared, Pelagia Katsimbri: None declared, Dimitrios Boumpas: None declared, Kalliopi Fragkiadaki: None declared, Maria Tektonidou: None declared, Petros Sfikakis: None declared, Konstantina Karagianni: None declared, Lazaros Sakkas: None declared, Gerasimos Evangelatos: None declared, Alexios Iliopoulos: None declared, Eleftheria Grika: None declared, PANAYIOTIS VLACHOYIANNOPOULOS: None declared, Theodoros Dimitroulas: None declared, Alexandros Garyfallos: None declared, Konstantinos Melissaropoulos: None declared, Panagiotis Georgiou: None declared, Maria Areti: None declared, Constantinos Georganas: None declared, Periklis Vounotrypidis: None declared, Georgios Georgiopoulos: None declared, George D Kitas Speakers bureau: GDK has received honoraria for lectures, participation in advisory boards and/or hospitality by Roche, Abbvie, Pfizer, Novartis, UCB, BMS, GSK and received grant support from Lilly., Dimitrios Vassilopoulos: None declared