{"id":8777,"date":"2025-07-14T12:43:51","date_gmt":"2025-07-14T11:43:51","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=8777"},"modified":"2025-12-02T08:59:27","modified_gmt":"2025-12-02T08:59:27","slug":"risk-of-infection-in-patients-with-early-inflammatory-arthritis-results-from-a-large-uk-prospective-observational-cohort-study-2025","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2025\/07\/14\/risk-of-infection-in-patients-with-early-inflammatory-arthritis-results-from-a-large-uk-prospective-observational-cohort-study-2025\/","title":{"rendered":"Risk of infection in patients with early inflammatory arthritis: results from a large UK prospective observational cohort study (2025)"},"content":{"rendered":"\n<p><strong>Type of publication:<\/strong><\/p>\n\n\n\n<p>Journal article<\/p>\n\n\n\n<p><strong>Author(s):<\/strong><\/p>\n\n\n\n<p>Adas, Maryam A; Bechman, Katie; Russell, Mark D; Allen, Victoria; Patel, Samir; Gibson, Mark; Karafotias, Ioasaf; Biddle, Kathryn; Zuckerman, Benjamin; Song, Kaiyang; Nagra, Deepak; Alveyn, Edward; Mahendrakar, Suma; Nursoy, Meryem; Atzeni, Fabiola; Gallagher, Sarah; Price, Elizabeth; *Garton, Mark; Rutherford, Andrew; Cope, Andrew P; Norton, Sam; Galloway, James B.<\/p>\n\n\n\n<p><strong>Citation:<\/strong><\/p>\n\n\n\n<p>Rheumatology. 2025 Nov 1;64(11):5647-5655<\/p>\n\n\n\n<p><strong>Abstract:<\/strong><\/p>\n\n\n\n<p>OBJECTIVE: To identify risk of serious infections-(SI) according to initial conventional synthetic disease modifying anti-rheumatic drugs-(csDMARD) and corticosteroids, in patients recruited to the National Early Inflammatory Arthritis Audit.<\/p>\n\n\n\n<p>METHODS: An observational cohort study was used, including adults in England and Wales with new diagnoses of rheumatoid arthritis-(RA) between 2018-2023. Main outcome was SI-events, defined as infections requiring hospitalisation\/or resulting in death. Secondary analyses evaluated SI-related mortality alone. Hazard ratios-(HR) were calculated using cox proportional hazards models. Primary predictor was initial treatment strategy, with confounder adjustments.<\/p>\n\n\n\n<p>RESULTS: 17 472 patients were included, of whom 10 997 on methotrexate-based strategies; 4,540 on other csDMARDs; 13 680 received corticosteroids. There were 1307 SI-events, corresponding to incidence<br>rates per 100 person-years of 3.02 (95% CI: 2.86-3.19) and 311 SI-related mortality (IR 0.69, 95% CI: 0.61-0.77). Methotrexate-based strategies were associated with reduced risk of SI-events compared with other csDMARDs (adjusted HR 0.72, 95% CI: 0.63-0.82). In unadjusted models, corticosteroid was associated with higher risk of SI-events, but in adjusted models this association was no longer significant (adjusted HR 0.99, 95% CI: 0.87-1.12). Increasing age, being a current\/or ex-smoker (relative to non-smoker), having a comorbidity, being seropositive, and having high DAS28 all associated with increased incidence of SI. One unit increase in baseline DAS28 increases the risk of SI-event by 10%.<\/p>\n\n\n\n<p>CONCLUSION: Methotrexate-based regimens associated with a reduced risk of SI compared with other strategies. Patient-level and disease-related factors at diagnosis are important predictors of SI in individuals with new RA.<\/p>\n\n\n\n<p><strong>DOI:&nbsp;<\/strong>10.1093\/rheumatology\/keaf312<\/p>\n\n\n\n<p><a href=\"https:\/\/academic.oup.com\/rheumatology\/advance-article\/doi\/10.1093\/rheumatology\/keaf312\/8157311?login=true\">Link to full-text<\/a> [open access no - password required]<\/p>\n\n\n\n<p><strong>Altmetrics:<\/strong>\n<div class=\"altmetric-embed\" data-badge-details=\"right\" data-badge-type=\"medium-donut\" data-pmid=\"40471746\" data-hide-no-mentions=\"true\"><\/div>\n<script type='text\/javascript' src='https:\/\/d1bxh8uas1mnw7.cloudfront.net\/assets\/embed.js'><\/script><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Type of publication: Journal article Author(s): Adas, Maryam A; Bechman, Katie; Russell, Mark D; Allen, Victoria; Patel, Samir; Gibson, Mark; Karafotias, Ioasaf; Biddle, Kathryn; Zuckerman, Benjamin; Song, Kaiyang; Nagra, Deepak; Alveyn, Edward; Mahendrakar, Suma; Nursoy, Meryem; Atzeni, Fabiola; Gallagher, Sarah;<span class=\"ellipsis\">&hellip;<\/span><\/p>\n<div class=\"read-more\"><a href=\"https:\/\/www.library.sath.nhs.uk\/research\/2025\/07\/14\/risk-of-infection-in-patients-with-early-inflammatory-arthritis-results-from-a-large-uk-prospective-observational-cohort-study-2025\/\">Read more <span class=\"screen-reader-text\">Risk of infection in patients with early inflammatory arthritis: results from a large UK prospective observational cohort study (2025)<\/span><span class=\"meta-nav\"> &#8250;<\/span><\/a><\/div>\n<p><!-- end of .read-more --><\/p>\n","protected":false},"author":12,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[1001,200],"tags":[1085,1002,991],"class_list":["post-8777","post","type-post","status-publish","format-standard","hentry","category-open-access","category-staff-publication","tag-1085","tag-gold-open-access","tag-rheumatology"],"_links":{"self":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/8777","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/comments?post=8777"}],"version-history":[{"count":3,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/8777\/revisions"}],"predecessor-version":[{"id":9495,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/posts\/8777\/revisions\/9495"}],"wp:attachment":[{"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/media?parent=8777"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/categories?post=8777"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.library.sath.nhs.uk\/research\/wp-json\/wp\/v2\/tags?post=8777"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}