@article{3119719,
    title = "Incidence, risk factors and validation of the RABBIT score for serious infections in a cohort of 1557 patients with rheumatoid arthritis",
    author = "Thomas, K. and Lazarini, A. and Kaltsonoudis, E. and Voulgari, P.V. and Drosos, A.A. and Repa, A. and Sali, A.M.I. and Sidiropoulos, P. and Tsatsani, P. and Gazi, S. and Evangelia, A. and Boki, K.A. and Katsimbri, P. and Boumpas, D. and Fragkiadaki, K. and Tektonidou, M.G. and Sfikakis, P.P. and Karagianni, K. and Sakkas, L.I. and Grika, E.P. and Vlachoyiannopoulos, P.G. and Evangelatos, G. and Iliopoulos, A. and Dimitroulas, T. and Garyfallos, A. and Melissaropoulos, K. and Georgiou, P. and Areti, M. and Georganas, C. and Vounotrypidis, P. and Georgiopoulos, G. and Kitas, G.D. and Vassilopoulos, D.",
    journal = "Rheumatology (United Kingdom)",
    year = "2021",
    volume = "60",
    number = "5",
    pages = "2223-2230",
    publisher = "Oxford University Press",
    doi = "10.1093/rheumatology/keaa557",
    keywords = "biological product;  corticosteroid;  disease modifying antirheumatic drug;  glucocorticoid;  hydroxychloroquine;  leflunomide;  methotrexate;  prednisolone;  antirheumatic agent, adult;  Article;  cardiovascular disease;  central nervous system infection;  chronic lung disease;  clinical feature;  cohort analysis;  combination drug therapy;  comorbidity;  comparative study;  controlled clinical trial;  controlled study;  DAS28;  demography;  diabetes mellitus;  disease duration;  disease risk assessment;  estimated glomerular filtration rate;  female;  gastrointestinal infection;  herpes zoster;  herpetic stomatitis;  hospitalization;  human;  incidence;  infection;  infection risk;  lung tuberculosis;  major clinical study;  male;  monotherapy;  multicenter study;  musculoskeletal disease assessment;  opportunistic infection;  parasitosis;  prospective study;  pyelonephritis;  respiratory tract infection;  rheumatoid arthritis;  rheumatoid arthritis observation of biologic therapy risk score;  skin infection;  skin structure;  spondylitis;  tuberculosis;  validation study;  virus infection;  aged;  middle aged;  opportunistic infection;  rheumatoid arthritis;  risk factor, Aged;  Antirheumatic Agents;  Arthritis, Rheumatoid;  Comorbidity;  Female;  Glucocorticoids;  Humans;  Incidence;  Infections;  Male;  Middle Aged;  Opportunistic Infections;  Risk Factors",
    abstract = "Objectives: Predicting serious infections (SI) in patients with rheumatoid arthritis (RA) is crucial for the implementation of appropriate preventive measures. Here we aimed to identify risk factors for SI and to validate the RA Observation of Biologic Therapy (RABBIT) risk score in real-life settings. Methods: A multi-centre, prospective, RA cohort study in Greece. Demographics, disease characteristics, treatments and comorbidities were documented at first evaluation and one year later. The incidence of SI was recorded and compared with the expected SI rate using the RABBIT risk score. Results: A total of 1557 RA patients were included. During follow-up, 38 SI were recorded [incidence rate ratio (IRR): 2.3/100 patient-years]. Patients who developed SI had longer disease duration, higher HAQ at first evaluation and were more likely to have a history of previous SI, chronic lung disease, cardiovascular disease and chronic kidney disease. By multivariate analysis, longer disease duration (IRR: 1.05; 95% CI: 1.005, 1.1), history of previous SI (IRR: 4.15; 95% CI: 1.7, 10.1), diabetes (IRR: 2.55; 95% CI: 1.06, 6.14), chronic lung disease (IRR: 3.14; 95% CI: 1.35, 7.27) and daily prednisolone dose ≥10 mg (IRR: 4.77; 95% CI: 1.47, 15.5) were independent risk factors for SI. Using the RABBIT risk score in 1359 patients, the expected SI incidence rate was 1.71/100 patient-years, not different from the observed (1.91/100 patient-years; P = 0.97). Conclusion: In this large real-life, prospective study of RA patients, the incidence of SI was 2.3/100 patient-years. Longer disease duration, history of previous SI, comorbidities and high glucocorticoid dose were independently associated with SI. The RABBIT score accurately predicted SI in our cohort. © 2020 The Author(s). Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved."
}