SAT0702-HPR FREQUENCY OF INFECTION AND PREDICTIVE FACTORS IN PATIENTS WITH BIOLOGICAL THERAPY
Authors: Uriel López Toledo, Sergio Cerpa-Cruz, Liliana Ivett Hernandez Cruz, Silvia Perez-Topete, Jennifer Samira Salcido Ledesma, Gloria Martinez-Bonilla, Veronica Gonzalez-Diaz, Sergio Gutierrez-Ureña
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Infections represent an important cause of morbidity and mortality for patients with autoimmune inflammatory rheumatic diseases. CsDMARDs have a low risk of infection; however, exposure to glucocorticoids seems to be an important predictor of infection. Therapy with bDMARDS is associated with a higher rate of severe infections compared to csDMARD. Objectives: to determine the prevalence and identify the predictive factors of infection in patients with autoimmune inflammatory rheumatic diseases with the use of biological therapy. <h3>Methods:</h3> Cross-sectional study, files of patients with autoimmune inflammatory rheumatic diseases were analyzed. Descriptive statistics were performed with mean, standard deviation and binary logistic regression to determine predictive factors of infection. We used SPSS software v. 21 (IL). <h3>Results:</h3> 54 patients were included, 37% diagnosed with RA, followed by SLE 15%, psoriasis arthritis 9%, ankylosing spondylitis in 7%, Sjögren's syndrome 5.6%. Fifty nine percent used glucocorticoids. Of the bDMARD the most used was Rituximab 65%, abatacept 25%, tocilizumab 5%, adalimumab 4%, etanercept 2% and infliximab 2%. The mean time of use was 28.8 ± 21.1 months. 54% had infection, mainly genitourinary 30%, pneumonia 15%, others as skin or gastrointestinal were presented with lower frequency, out of all infections only 12% required hospitalization (serious adverse events). No positive predictive factors for infection were found with the use of bDMARD, but adding this variable increased the risk of infection by 5%, however the use of concomitant therapy with mycophenolic acid was the most predictive risk for the presence of infection with an OR = 9,143 (95% CI 1.055 - 79.26) p = 0.045. Conclusion: the patients on bDMARD presented a significant percentage of infections, in this study it was not shown that the use of biological therapy was a predictive factor for the risk of infections, but with the concomitant use of mycophenolic acid appears to increase the risk. <h3>References</h3> [1] Cipriani P, Berardicurti O, Masedu F, D'Onofrio F, Navarini L, Ruscitti P, et al. Biologic therapies and infections in the daily practice of three Italian rheumatologic units: a prospective, observational study. Clin Rheumatol. febrero de 2017;36(2):251-60. [2] atoid arthritis. Arthritis Care Res. julio de 2014;66(7):990-7.Curtis JR, Yang S, Patkar NM, Chen L, Singh JA, Cannon GW, et al. Risk of hospitalized bacterial infections associated with biologic treatment among US veterans with rheum [3] Yun H, Xie F, Delzell E, Levitan EB, Chen L, Lewis JD, et al. Comparative Risk of Hospitalized Infection Associated With Biologic Agents in Rheumatoid Arthritis Patients Enrolled in Medicare. Arthritis Rheumatol Hoboken NJ. enero de 2016;68(1):56-66. <h3>Disclosure of Interests:</h3> None declared