Hospitalized Infection rates among BiologicTreated RA Patients Concurrently Treated with Denosumab A & R http://t.co/D6FE0QbuaL
Methods
We identified RA patients enrolled in Medicare in 2006-2012 treated with biologics who initiated Dmab or ZA. Cox proportional hazards models compared the risk for hospitalized infection, comparing denosumab to ZA users and adjusting for potentially confounding factors . A non-inferiority margin was specified a-priori to demonstrate that denosumab had no greater infection risk than ZA if the upper bound of the 95% CI of the hazard ratio (HR) was less than 1.5.
Results
Eligible RA patients receiving biologics initiated denosumab (n=1,354) or ZA (n=4,460). Characteristics of the denosumab users: mean (SD) age 73.0(8.9), 98.2% women, with a majority receiving infliximab (35.7%) or abatacept (18.6%). Denosumab users had a higher prevalence of prior infections (11.5% hospitalized, 48.3% outpatient) and infection-related risk factors. The crude rate of hospitalized infection for Dmab (14.9/100py; 95% CI 12.2-18.1) was comparable to ZA (13.9/100py; 95% CI 12.5-15.4). After adjustment, the HR of hospitalized infection for denosumab users was non-inferior to ZA (HR=0.89, 95% CI 0.69 - 1.15)
Conclusion
The rate of hospitalized infection among RA patients receiving denosumab concurrently with biologics for RA was not increased compared to zoledronate.
Via Krishan Maggon
DOI: 10.1002/art.39075
© 2015 American College of Rheumatology
Issue
Arthritis & RheumatologyAccepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)