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Patients with rheumatoid arthritis had greater risk for influenza
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Patients with rheumatoid arthritis had an increased risk for seasonal influenza and its complications compared with matched controls, according to study results.
Researchers analyzed a large US commercial health insurance database from January 2000 through December 2007 to study 46,030 patients with rheumatoid arthritis (RA) and an equal number of controls (median age, 57 years; 66% women). Incidence of seasonal influenza and its complications at or up to 30 days after diagnosis, medical conditions, use of disease-modifying antirheumatic drugs (DMARDs), use of biological agents, influenza vaccination and high- or low-dose corticosteroids were evaluated.
Patients with RA had a higher incidence rate of influenza compared with controls (409.33 vs. 306.12 cases per 100,000 patient-years), and 2.75 times the rate of complications (74.76 vs. 27.15 cases per 100,000 patient-years). The effects of DMARDs or biologics were not significant. Men with RA aged 30 to 39 years had the greatest number of influenza cases compared with controls (761.26 vs. 347.99 per 100,000 patient-years). Patients aged 60 to 69 years, particularly men, had a statistically significant adjusted incident rate ratio of influenza (IRR=1.94; 95% CI, 1.31-2.86).
Significantly increased rates of influenza complications were observed among cumulative baseline-adjusted women’s age groups (IRR=2.17; 95% CI, 1.22-3.86) and both combined genders (IRR=1.82; 95% CI, 1.16-2.81). Combined men’s age groups did not reach significance (IRR=1.30; 95% CI, 0.64-2.63). Women with RA had significantly greater rates of pneumonia complications compared with controls (105.54 vs. 38.34 per 100,000 patient-years), while men had higher rates of stroke/myocardial infarction (MI) vs. controls (63.52 vs. 14.24 per 100,000 patient-years).
“RA is associated with increased risk of seasonal influenza and its complications specifically, concordant with the position now being taken by the CDC on influenza risk in patients with inflammatory rheumatic disease,” the researchers concluded. “Data indicate that women generally have a greater rate of complications than men, but that men primarily have an increased rate of stroke and MI complications.”
Disclosure: All study authors are employees of or consultants to Roche or Genentech.
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