PMID- 31338986
OWN - NLM
STAT- MEDLINE
DCOM- 20200413
LR  - 20200413
IS  - 1756-185X (Electronic)
IS  - 1756-1841 (Linking)
VI  - 22
IP  - 11
DP  - 2019 Nov
TI  - Risk of opportunistic infections in patients with antineutrophil cytoplasmic 
      antibody-associated vasculitis, using a Japanese health insurance database.
PG  - 1978-1984
LID - 10.1111/1756-185X.13662 [doi]
AB  - AIM: Opportunistic infections (OIs) adversely affect outcomes in patients with 
      antineutrophil cytoplasmic antibody-associated vasculitis (AAV). This study aimed 
      to identify the incidence proportion of risk factors for OIs in patients with AAV 
      who were on remission-induction therapy, using a Japanese health insurance 
      database. METHOD: This retrospective longitudinal population-based study was 
      conducted using claims data provided by Medical Data Vision Co., Ltd. We defined 
      individuals as AAV cases receiving remission-induction therapy if they met all of 
      the following criteria: (a) having OIs with at least 1 specified International 
      Statistical Classification of Diseases and Related Health Problems, 10th Revision 
      code (M300, M301, M313, or M318); (b) receiving at least 1 prescription of oral 
      corticosteroids (CS) with prednisolone (PSL)-equivalent dosage >/=30 mg/d, CS pulse 
      therapy, immunosuppressive agents or rituximab during hospitalization between 
      April 2008 and April 2017; and (c) at least 7 days of hospitalization while on 
      the above-mentioned therapies. We calculated incidence and proportion of OIs 
      during the year following remission-induction therapy and the adjusted odds ratio 
      (OR) using a logistic regression model. RESULTS: We included 2299 patients with 
      AAV in this study. OIs occurred in 460 patients (20.0%), with the most frequently 
      occurring OI being cytomegalovirus infection (n = 122, 6.5%). After adjusting for 
      covariates, age by decade (OR 1.24, 95% CI: 1.12-1.36), daily PSL dose per 10 mg 
      (OR 1.16, 95% CI: 1.08-1.25), and CS pulse therapy (OR 1.29, 95% CI: 1.04-1.60) 
      were found to be significantly associated with occurrence of OIs. CONCLUSION: 
      Older age and corticosteroid use were found to be significant risk factors for 
      OIs in patients with AAV on remission-induction therapy, using a health insurance 
      database.
CI  - (c) 2019 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons 
      Australia, Ltd.
FAU - Sakai, Ryoko
AU  - Sakai R
AUID- ORCID: 0000-0002-1640-1373
AD  - Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, 
      Department of Rheumatology, School of Medicine, Tokyo Women's Medical University, 
      Tokyo, Japan.
AD  - Department of Rheumatology, School of Medicine, Tokyo Women's Medical University, 
      Tokyo, Japan.
FAU - Tanaka, Eiichi
AU  - Tanaka E
AD  - Department of Rheumatology, School of Medicine, Tokyo Women's Medical University, 
      Tokyo, Japan.
FAU - Nishina, Hirokazu
AU  - Nishina H
AD  - Department of Rheumatology, School of Medicine, Tokyo Women's Medical University, 
      Tokyo, Japan.
FAU - Suzuki, Masayoshi
AU  - Suzuki M
AD  - EBM Divition, EBM Unit, Medical Data Vision Co., Ltd, Tokyo, Japan.
FAU - Yamanaka, Hisashi
AU  - Yamanaka H
AD  - Department of Rheumatology, School of Medicine, Tokyo Women's Medical University, 
      Tokyo, Japan.
FAU - Harigai, Masayoshi
AU  - Harigai M
AUID- ORCID: 0000-0002-6418-2603
AD  - Division of Epidemiology and Pharmacoepidemiology of Rheumatic Diseases, 
      Department of Rheumatology, School of Medicine, Tokyo Women's Medical University, 
      Tokyo, Japan.
AD  - Department of Rheumatology, School of Medicine, Tokyo Women's Medical University, 
      Tokyo, Japan.
LA  - eng
GR  - JP17ek0109121/The Japan Agency for Medical Research and Development/
PT  - Journal Article
DEP - 20190723
PL  - England
TA  - Int J Rheum Dis
JT  - International journal of rheumatic diseases
JID - 101474930
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adrenal Cortex Hormones/administration & dosage/adverse effects
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis/drug 
      therapy/*epidemiology/immunology
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Immunocompromised Host
MH  - Immunosuppressive Agents/administration & dosage/adverse effects
MH  - Incidence
MH  - Japan/epidemiology
MH  - Longitudinal Studies
MH  - Male
MH  - National Health Programs
MH  - Opportunistic Infections/diagnosis/*epidemiology/immunology
MH  - Pulse Therapy, Drug
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - antineutrophil cytoplasmic antibody-associated vasculitis
OT  - drug treatment opportunistic infection
OT  - epidemiology
OT  - risk
EDAT- 2019/07/25 06:00
MHDA- 2020/04/14 06:00
CRDT- 2019/07/25 06:00
PHST- 2019/04/22 00:00 [received]
PHST- 2019/06/10 00:00 [revised]
PHST- 2019/06/25 00:00 [accepted]
PHST- 2019/07/25 06:00 [pubmed]
PHST- 2020/04/14 06:00 [medline]
PHST- 2019/07/25 06:00 [entrez]
AID - 10.1111/1756-185X.13662 [doi]
PST - ppublish
SO  - Int J Rheum Dis. 2019 Nov;22(11):1978-1984. doi: 10.1111/1756-185X.13662. Epub 
      2019 Jul 23.