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Glucocorticoids Linked to Hospitalized Infection Risk in RA

Risk for hospitalized infections up for patients with RA receiving DMARDs with continued glucocorticoid use

TUESDAY, Sept. 22, 2020 (HealthDay News) — For patients with rheumatoid arthritis (RA) receiving disease-modifying antirheumatic drug (DMARD) therapy, continued use of glucocorticoids is associated with an increased risk for hospitalized infections, according to a study published online Sept. 22 in the Annals of Internal Medicine.

Michael D. George, M.D., from the University of Pennsylvania in Philadelphia, and colleagues quantified the risk for hospitalized infection with long-term use of low-dose glucocorticoids in a cohort of adults with RA receiving DMARD therapy. A total of 247,297 observations were identified in 172,041 Medicare patients, and 58,279 observations were identified in 44,118 patients in Optum.

The researchers found that 47.1 percent of Medicare patients and 39.5 percent of Optum patients were receiving glucocorticoids after six months of stable DMARD use. In Medicare patients not receiving glucocorticoids, the one-year cumulative incidence of hospitalized infection was 8.6 percent versus 11.0, 14.4, and 17.7 percent for a glucocorticoid dose of 5 mg or less/day, greater than 5 to 10 mg/day, and greater than 10 mg/day, respectively. In Optum patients not receiving glucocorticoids, the one-year cumulative incidence of hospitalized infection was 4.0 percent versus 5.2, 8.1, and 10.6 percent for a glucocorticoid dose of 5 mg or less/day, greater than 5 to 10 mg/day, and greater than 10 mg/day, respectively.

“Clinicians should avoid long-term use of higher-dose glucocorticoids and should weigh the benefits of low-dose therapy in individual patients with these potential risks,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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