A retrospective, real-world study on serious infection risk in a multiracial rheumatoid arthritis population on advanced therapies
- 1Division of Rheumatology, Department of Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
- 2Division of Infectious Disease, Department of Medicine, Faculty of Medicine, Universiti Malaya, Malaysia
- 3Department of Surgery, Faculty of Medicine, Universiti Malaya, Malaysia
Abstract
Objective: Advanced therapies have revolutionized the treatment landscape for rheumatoid arthritis. However, concerns exist regarding the risk of serious infections among patients receiving these therapies. This study aimed to determine the incidence of serious infections and identify predictive factors associated with serious infections in patients with rheumatoid arthritis receiving advanced therapies.
Methods: This single-center retrospective cohort study reviewed patients with rheumatoid arthritis who attended the rheumatology clinic and/or ward at Universiti Malaya Medical Centre between January 2006 and December 2023. Patient demographic and clinical data, as well as data on treatment with advanced therapies, were collected. Logistic regression analyses were used to identify predictors of serious infections.
Results: Of the 423 patients with rheumatoid arthritis identified, 87% were female. The mean age was 61.0 (SD: 13.8) years, and 80 (18.9%) received at least one advanced therapy. Sixteen (20%) patients developed serious infections, with a total of 23 serious infection episodes reported. The overall incidence rate of serious infections was 3.75 per 100 patient-years. Respiratory infections were the most common (52.2%), and tumor necrosis factor inhibitors had the highest incidence rate (4.25/100 patient-years) among the various classes of advanced therapies. Diabetes mellitus (odds ratio = 4.508, 95% confidence interval: 1.246–16.316; p = 0.022) and lung disease (odds ratio = 4.554, 95% confidence interval: 1.056–19.637; p = 0.042) were independent predictors of serious infections.
Conclusion: Serious infections may develop among patients with rheumatoid arthritis receiving advanced therapy, with lung disease and diabetes mellitus identified as independent risk factors. This study may help improve clinicians’ awareness of the real-world risks associated with initiating advanced therapy. Future studies with a larger sample size are warranted to expand upon these findings.
Related
- Validation of the Brief-Cope Questionnaire in a Seropositive Rheumatoid Arthritis Population
- Pan-immune-inflammation value and sleep disturbances in rheumatoid arthritis : A population-based NHANES study
- An Active Cytomegalovirus Infection and Epstein-Barr Virus Reactivation Complicated by Cytomegalovirus Meningitis and Virus-Associated Hemophagocytic Lymphohistiocytosis during Methotrexate and Upadacitinib Therapy in a Patient with Rheumatoid Arthritis
- Lung Ultrasound in Rheumatoid Arthritis–Associated Interstitial Lung Disease: Association with Radiological Patterns, Lung Function Tests, and Disease Activity—A Single-Center Retrospective Cross-Sectional Study
- Disseminated Varicella-Zoster Virus Infection Following a Live Attenuated Varicella Vaccine (Oka Strain) in a Patient with Rheumatoid Arthritis: A Case Report
BibTeX
@article{tan2026retrospective,
title = {{A retrospective, real-world study on serious infection risk in a multiracial rheumatoid arthritis population on advanced therapies}},
author = {Joanna Janice Tan and Say Lee Pok and Pui Li Wong and Ahmad Rafizi Hariz Ramli and Fariz Yahya},
journal = {The Journal of International Medical Research},
year = {2026},
month = sep,
doi = {10.1177/03000605261491008},
url = {https://doi.org/10.1177/03000605261491008},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - A retrospective, real-world study on serious infection risk in a multiracial rheumatoid arthritis population on advanced therapies
AU - Joanna Janice Tan
AU - Say Lee Pok
AU - Pui Li Wong
AU - Ahmad Rafizi Hariz Ramli
AU - Fariz Yahya
PY - 2026
DA - 2026/09/27
JO - The Journal of International Medical Research
DO - 10.1177/03000605261491008
UR - https://doi.org/10.1177/03000605261491008
AB - Objective: Advanced therapies have revolutionized the treatment landscape for rheumatoid arthritis. However, concerns exist regarding the risk of serious infections among patients receiving these therapies. This study aimed to determine the incidence of serious infections and identify predictive factors associated with serious infections in patients with rheumatoid arthritis receiving advanced therapies. Methods: This single-center retrospective cohort study reviewed patients with rheumatoid arthritis who attended the rheumatology clinic and/or ward at Universiti Malaya Medical Centre between January 2006 and December 2023. Patient demographic and clinical data, as well as data on treatment with advanced therapies, were collected. Logistic regression analyses were used to identify predictors of serious infections. Results: Of the 423 patients with rheumatoid arthritis identified, 87% were female. The mean age was 61.0 (SD: 13.8) years, and 80 (18.9%) received at least one advanced therapy. Sixteen (20%) patients developed serious infections, with a total of 23 serious infection episodes reported. The overall incidence rate of serious infections was 3.75 per 100 patient-years. Respiratory infections were the most common (52.2%), and tumor necrosis factor inhibitors had the highest incidence rate (4.25/100 patient-years) among the various classes of advanced therapies. Diabetes mellitus (odds ratio = 4.508, 95% confidence interval: 1.246–16.316; p = 0.022) and lung disease (odds ratio = 4.554, 95% confidence interval: 1.056–19.637; p = 0.042) were independent predictors of serious infections. Conclusion: Serious infections may develop among patients with rheumatoid arthritis receiving advanced therapy, with lung disease and diabetes mellitus identified as independent risk factors. This study may help improve clinicians’ awareness of the real-world risks associated with initiating advanced therapy. Future studies with a larger sample size are warranted to expand upon these findings.
SN - 0300-0605
SN - 1473-2300
ER -