Risk factors for infection in patients with remitted rheumatic diseases treated with glucocorticoids.
It is well known that infection is one of the major causes of morbidity and mortality in rheumatic disease patients treated with high-dose glucocorticoids, especially in the early phase after achievement of disease remission. The aim of this study was to identify the risk factors for infection, with a focus on the dose of glucocorticoids administered, following the achievement of disease remission in rheumatic diseases patients. We retrospectively analyzed the medical records of rheumatic disease patients who had been treated with glucocorticoids. The primary endpoint was the incidence rate of infection during a period from 1 to 2 months after the commencement of treatment. From April 2006 to March 2010, 19 of 92 patients suffered from infection during the observation period. Age ≧ 65 yrs, presence of interstitial pneumonia, diagnosis of systemic vasculitis and serum creatinine level ≧ 2.0 mg/dl were found to be univariate predictors for infection. However, only the presence of interstitial pneumonia was an independent risk factor for infection (HR＝4.50, 95%CI＝1.65 to 14.44) by the Cox proportional hazard model. Even after achievement of clinical remission, careful observation is needed for patients with interstitial pneumonia, more so than for those receiving high-dose glucocorticoids.
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Yoshinori
Y
Matsumoto
Ken-ei
KE
Sada
Mariko
M
Takano
Noriko
N
Toyota
Ryutaro
R
Yamanaka
Koichi
K
Sugiyama
Hiroshi
H
Wakabayashi
Tomoko
T
Kawabata
Fumio
F
Otsuka
Hirofumi
H
Makino
D000328:Adult; D000368:Aged; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D007239:Infections / Q000209:etiology*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D016016:Proportional Hazards Models; D012074:Remission Induction; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D012307:Risk Factors
D005938:Glucocorticoids; D007166:Immunosuppressive Agents