Method: A cohort of all RA patients (N = 112) receiving tocilizumab therapy between October 2008 and March 2010 in Northern Bavaria, Germany, was assessed for the incidence of infections. Mild/moderate and severe infections were recorded. Multivariate logistic regression analysis was used to analyze risk factors for infection.
Results: In total, 26 patients developed infections (23.2%, 58.0/100py), 18 of them experienced mild to moderate infections (16.1%, 40.1/100py) and 8 faced severe infections (7.1%, 17.9/100py). One patient died. Concomitant use of leflunomide and prednisone, high disease activity and previous therapy with rituximab were associated with the occurrence of mild/moderate infections. Severe infections were related to age, longer disease duration, exposure to more than 3 previous DMARDs and concomitant therapy with proton pump inhibitors (PPI).
Conclusion: The rate of infection in RA patients treated with tocilizumab in clinical practice is higher compared with the populations in clinical trials. Increased awareness should especially be given to patients with higher age and longer disease duration, those concomitantly using leflunomide, prednisone or PPI as well as those with a previous exposure to rituximab.
Disclosure: V. Lang, None; M. Englbrecht, None; J. Rech, None; B. Manger, None; G. Schett, None; J. Zwerina, None.