SAT0470 RISK OF HOSPITAL ADMISSION DUE TO INFECTION IN PATIENTS UNDERGOING TREATMENT WITH BIOLOGICAL THERAPY: CASE-CONTROL STUDY
Authors: Jose Rosas, Ana Pons, José Alberto García-Gómez, José Miguel Senabre-Gallego, Gregorio Santos Soler, Esteban Salas-Heredia, José Antonio Bernal-Vidal, Catalina Cano, Estíbaliz Ivars, Xavier Barber
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Objectives</h3> To know risk of admission due to infection in patients treated with biological drugs (DMARDb). <h3>Methods</h3> Case-control study, in patients admitted for infection, treated with DMARDb, from 2000-2018. As a control group, patients included, in treatment with conventional synthetic DMARDs (DMARDcs). General data (age, gender), disease (diagnosis, time evolution, DMARDb, time in DMARDb, DMARDcs); and infection (time in DMARDb to infection, location of infection, more than one admission). <h3>Results</h3> Of 364 patients, 48 (13%) admitted for infection: 32 (9%) treated with DMARDb, 16 (4%) with DMARDcs alone. When comparing patients admitted vs who do not, RA predominates and no differences in the treatment with DMARDb and/or DMARDcs, corticosteroids, type of DMARD or the infection. Of 275 patients with DMARDb, 41 admissions for infection in 32 patients (11.6%); more than once. 20 (62.5%), were women, with mean age 69.2±2.12 years, mean time evolution 24.5±22.6 years. Diagnosis was RA: 22 (69%) patients, ankylosing spondylitis: 7 (22%), psoriatic arthritis: 3 (9%). Concomitant with DMARDcs in 81% and 26% corticosteroid (mean dose: 4.6±2.6 mg). The diagnosis of 41 admitted was: Pneumonia: 9 (41%), non-pneumonic respiratory infection: 5 (24%), septic arthritis: 8 (24%), urinary infection-pyelonephritis urinary o sepsis: 8 (22%), influenza A: 3 (7%), abscess, gastroenteritis and leishmaniasis in 2 (5%) each, osteomyelitis and varicella in 1 (2%) each. The DMARDb at admission were: anti-TNF: 34 (83%) patients (adalimumab: 19/46%, etanercept: 7/17%, infliximab: 4/10%, golimumab and certolizumab: 2/5% each), tocilizumab: 4 (10%), abatacept: 2 (5%). When comparing patients admitted for infection, patients with DMARDb has higher number of admissions (41 (67%) vs 20 (33%), p &lt;0.01), and lower percentage of DMARDcs (23/72%) vs 16 (100%). p=0.02) and corticosteroids (14/34% vs 10/50%). p &lt;0.001), at similar doses (4.7±2.6 vs 4.5±2.6 mg, p = 0.7). The incidence of admission for infection are indicated in table. <h3>Conclusion</h3> 1. The prevalence of admission due to infection in DMARDb is 9% and 4% in DMARDs in monotherapy. 2. Admission predominates in RA, with a long evolution, with biological therapy. 2. The most frequent infections were respiratory origin, followed by sepsis or bacteremia and septic arthritis. <h3>Acknowledgement</h3> The study was supported with a research grant from the Association for Research in Rheumatology of Marina Baixa (AIRE-MB). <h3>Disclosure of Interests</h3> Jose Rosas Consultant for: Abbvie, Amgen, Bristol, Janssen, Lilly, Merck Sharp &amp; Dohme, Pfizer, UCB Pharma, Speakers bureau: Abbvie, Amgen, Bristol, Janssen, Lilly, Merck Sharp &amp; Dohme, Pfizer, UCB Pharma, Ana Pons: None declared, José Alberto García-Gómez: None declared, José Miguel Senabre-Gallego: None declared, Gregorio Santos Soler: None declared, Esteban Salas-Heredia: None declared, José Antonio Bernal-Vidal: None declared, Catalina Cano: None declared, Estíbaliz Ivars: None declared, Xavier Barber: None declared