Universität zu Köln

Thiele, Franz ORCID: 0000-0001-6689-8827, Klein, Ariane, Windschall, Daniel, Hospach, Anton, Foeldvari, Ivan ORCID: 0000-0003-0659-5298, Minden, Kirsten, Weller-Heinemann, Frank and Horneff, Gerd (2021). Comparative risk of infections among real-world users of biologics for juvenile idiopathic arthritis: data from the German BIKER registry. Rheumatol. Int., 41 (4). S. 751 - 763. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1437-160X

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Abstract

To examine whether treatment with interleukin (IL)-1-, IL-6-, tumour necrosis factor alpha (TNF alpha)-inhibitors or Abatacept is associated with an increased risk of common infections, infections requiring hospitalization (SAE) or opportunistic infections among real-world juvenile idiopathic arthritis (JIA) patients. Furthermore, the influence of other patient-related covariates on the occurrence of infections was investigated. Patients diagnosed with JIA and treated with biologics were selected from the German BIKER registry. Incidence rates (IR) of infections per 100 person years were calculated and compared between the different cohorts. Using multivariate logistic regression, odds ratios with 95% confidence intervals (CI) were determined for the influence of patient-related covariates (age, diagnosis, laboratory data, concomitant medication, JIA activity, comorbidities, and premedication) on the occurrence of infections. 3258 patients entered the analysis. A total of 3654 treatment episodes were distributed among TNF alpha- (Etanercept, Adalimumab, Golimumab, Infliximab, n = 3044), IL-1- (Anakinra, Canakinumab, n = 105), IL-6- (Tocilizumab, n = 400) and T-cell activation inhibitors (Abatacept, n = 105). 813 (22.2%) patients had at least one infection, 103 (2.8%) patients suffered from an SAE infection. Both common and SAE infections were significantly more frequent in IL-1 (IR 17.3, 95% CI 12.5/24 and IR 4.3, 95% CI 2.3/8.3) and IL-6 cohort (IR 16.7, 95% CI 13.9/20 and IR 2.8, 95% CI 1.8/4.4) compared to TNF alpha-inhibitor cohort (IR 8.7, 95% CI 8.1/9.4 and IR 1, 95% CI 0.8/1.3). When comparing the influencing factors for various infectious diseases, the use of corticosteroids, younger age, cardiac comorbidities and higher JIA-activity are the most striking risk factors. Relative to TNF alpha inhibitors and Abatacept, IL-1 and IL-6 inhibitors were associated with an increased risk of common and SAE infections. The influencing covariates identified may be helpful for the choice of a suitable biologic to treat JIA.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Thiele, Franz UNSPECIFIED orcid.org/0000-0001-6689-8827 UNSPECIFIED Klein, Ariane UNSPECIFIED UNSPECIFIED UNSPECIFIED Windschall, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hospach, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Foeldvari, Ivan UNSPECIFIED orcid.org/0000-0003-0659-5298 UNSPECIFIED Minden, Kirsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Weller-Heinemann, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Horneff, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-591939
DOI:	10.1007/s00296-020-04774-3
Journal or Publication Title:	Rheumatol. Int.
Volume:	41
Number:	4
Page Range:	S. 751 - 763
Date:	2021
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1437-160X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Rheumatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59193