Factors Associated with Severe Skin Infections in Patients Treated with Biologic Therapies for Inflammatory Rheumatic Diseases
Regnier–Rosencher E et al. – In patients under biologic therapies for inflammatory rheumatic diseases (IRD), the risk of severe skin infections (SSI) is associated with several factors including tobacco, treatment with infliximab or high dose range.Methods
- The authors performed a case–control (ratio 1:3) study nested in a prospective cohort of patients with IRD.
- SSI was defined as requiring hospitalization or intravenous anti–infectious therapy.
- They defined two imbedded periods: period A was the time window between the first biologic therapy and the SSI; period B was the last 3 or 12 months (for tumor necrosis factor blockers or rituximab, respectively) before the SSI.
- Among 4,361 patients with IRD, 29 had a SSI under biologic therapy.
- In multivariate analyses, SSI were significantly associated with smoking, baseline C–reactive protein and gammaglobulinemia, non–steroidal anti–inflammatory drugs before biologic therapy, cumulative dose of steroids, concomitant steroids during period A, number of different biologic therapies during period A, treatment with infliximab during period A, period B or as first biologic therapy and treatment at high dose during period B.