Haematological abnormalities in new onset rheumatoid arthritis and risk of common infections: a population-based study

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Haematological abnormalities in new onset rheumatoid arthritis and risk of common infections : a population-based study. / Nikiphorou, Elena; de Lusignan, Simon; Malen, Christian; Khavandi, Kaivan; Roberts, Jaqueline ; Buckley, Christopher; Galloway, James; Raza, Karim.

In: Rheumatology (Oxford, England), 09.09.2019.

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Nikiphorou, Elena ; de Lusignan, Simon ; Malen, Christian ; Khavandi, Kaivan ; Roberts, Jaqueline ; Buckley, Christopher ; Galloway, James ; Raza, Karim. / Haematological abnormalities in new onset rheumatoid arthritis and risk of common infections : a population-based study. In: Rheumatology (Oxford, England). 2019.

Bibtex

@article{f9c824f867c442f8a6754f60229d2f5f,
title = "Haematological abnormalities in new onset rheumatoid arthritis and risk of common infections: a population-based study",
abstract = "Objectives: To describe the prevalence of haematological abnormalities in individuals with rheumatoid arthritis (RA) at the point of diagnosis in primary care, and the associations between haematological abnormalities, vaccinations and subsequent risk of common infections. Methods: We studied 6,591 individuals with newly diagnosed RA between 2004 and 2016 inclusive using the UK Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database. The prevalence of haematological abnormalities at diagnosis (anaemia, neutropenia and lymphopenia) was established. Cox proportional hazards models were used to evaluate i) the association between each haematological abnormality and time to common infections; ii) the influence of vaccination status (influenza and pneumococcal vaccine) on time to common infections in individuals with RA, compared with a matched cohort of individuals without RA.Results: Anaemia was common at RA diagnosis (16.1% of individuals), neutropenia (0.6%) and lymphopenia (1.4%) less so. Lymphopenia and anaemia were associated with increased infection risk (respective hazard ratios (HR) 1.18 (95%CI 1.08-1.29); HR 1.37 (95%CI 1.08-1.73)). There was no evidence of an association between neutropenia and infection risk (HR 0.94 (95%CI 0.60-1.47). Pneumonia was much more common in individuals with early RA compared with controls. Influenza vaccination was associated with reduced risk of influenza-like illness only for individuals with RA (HR 0.58 (95% CI 0.37-0.90). Conclusion: At diagnosis, anaemia and lymphopenia, but not neutropenia, increase the risk of common infections in individuals with RA. Our data support the effectiveness of the influenza vaccination in individuals with RA. ",
keywords = "anaemia, infection, influenza, influenza vaccine, lymphopenia, neutropenia, pneumococcal vaccine, rheumatoid arthritis",
author = "Elena Nikiphorou and {de Lusignan}, Simon and Christian Malen and Kaivan Khavandi and Jaqueline Roberts and Christopher Buckley and James Galloway and Karim Raza",
year = "2019",
month = sep,
day = "9",
doi = "10.1093/rheumatology/kez344",
language = "English",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",

}

RIS

TY - JOUR

T1 - Haematological abnormalities in new onset rheumatoid arthritis and risk of common infections

T2 - a population-based study

AU - Nikiphorou, Elena

AU - de Lusignan, Simon

AU - Malen, Christian

AU - Khavandi, Kaivan

AU - Roberts, Jaqueline

AU - Buckley, Christopher

AU - Galloway, James

AU - Raza, Karim

PY - 2019/9/9

Y1 - 2019/9/9

N2 - Objectives: To describe the prevalence of haematological abnormalities in individuals with rheumatoid arthritis (RA) at the point of diagnosis in primary care, and the associations between haematological abnormalities, vaccinations and subsequent risk of common infections. Methods: We studied 6,591 individuals with newly diagnosed RA between 2004 and 2016 inclusive using the UK Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database. The prevalence of haematological abnormalities at diagnosis (anaemia, neutropenia and lymphopenia) was established. Cox proportional hazards models were used to evaluate i) the association between each haematological abnormality and time to common infections; ii) the influence of vaccination status (influenza and pneumococcal vaccine) on time to common infections in individuals with RA, compared with a matched cohort of individuals without RA.Results: Anaemia was common at RA diagnosis (16.1% of individuals), neutropenia (0.6%) and lymphopenia (1.4%) less so. Lymphopenia and anaemia were associated with increased infection risk (respective hazard ratios (HR) 1.18 (95%CI 1.08-1.29); HR 1.37 (95%CI 1.08-1.73)). There was no evidence of an association between neutropenia and infection risk (HR 0.94 (95%CI 0.60-1.47). Pneumonia was much more common in individuals with early RA compared with controls. Influenza vaccination was associated with reduced risk of influenza-like illness only for individuals with RA (HR 0.58 (95% CI 0.37-0.90). Conclusion: At diagnosis, anaemia and lymphopenia, but not neutropenia, increase the risk of common infections in individuals with RA. Our data support the effectiveness of the influenza vaccination in individuals with RA.

AB - Objectives: To describe the prevalence of haematological abnormalities in individuals with rheumatoid arthritis (RA) at the point of diagnosis in primary care, and the associations between haematological abnormalities, vaccinations and subsequent risk of common infections. Methods: We studied 6,591 individuals with newly diagnosed RA between 2004 and 2016 inclusive using the UK Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care database. The prevalence of haematological abnormalities at diagnosis (anaemia, neutropenia and lymphopenia) was established. Cox proportional hazards models were used to evaluate i) the association between each haematological abnormality and time to common infections; ii) the influence of vaccination status (influenza and pneumococcal vaccine) on time to common infections in individuals with RA, compared with a matched cohort of individuals without RA.Results: Anaemia was common at RA diagnosis (16.1% of individuals), neutropenia (0.6%) and lymphopenia (1.4%) less so. Lymphopenia and anaemia were associated with increased infection risk (respective hazard ratios (HR) 1.18 (95%CI 1.08-1.29); HR 1.37 (95%CI 1.08-1.73)). There was no evidence of an association between neutropenia and infection risk (HR 0.94 (95%CI 0.60-1.47). Pneumonia was much more common in individuals with early RA compared with controls. Influenza vaccination was associated with reduced risk of influenza-like illness only for individuals with RA (HR 0.58 (95% CI 0.37-0.90). Conclusion: At diagnosis, anaemia and lymphopenia, but not neutropenia, increase the risk of common infections in individuals with RA. Our data support the effectiveness of the influenza vaccination in individuals with RA.

KW - anaemia

KW - infection

KW - influenza

KW - influenza vaccine

KW - lymphopenia

KW - neutropenia

KW - pneumococcal vaccine

KW - rheumatoid arthritis

U2 - 10.1093/rheumatology/kez344

DO - 10.1093/rheumatology/kez344

M3 - Article

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

ER -