Evaluation of the RABBIT Risk Score for serious infections
Open Access
- 5 June 2013
- journal article
- research article
- Published by BMJ in Annals Of The Rheumatic Diseases
- Vol. 73 (9), 1673-1676
- https://doi.org/10.1136/annrheumdis-2013-203341
Abstract
Objective To evaluate the Rheumatoid Arthritis Observation of Biologic Therapy (RABBIT) Risk Score for serious infections in patients with rheumatoid arthritis (RA). Methods The RABBIT Risk Score for serious infections was developed in 2011 on a cohort of RA patients enrolled in the German biologics register RABBIT between 2001 and 2007. To evaluate this score, we used data from patients enrolled in RABBIT after 1 January 2009. Expected numbers of serious infections and expected numbers of patients with at least one serious infection per year were calculated by means of the RABBIT Risk Score and compared with observed numbers in the evaluation sample. Results The evaluation of the score in an independent cohort of 1522 RA patients treated with tumour necrosis factor α (TNFα) inhibitors and 1468 patients treated with non-biological disease-modifying antirheumatic drugs (DMARDs) showed excellent agreement between observed and expected rates of serious infections. For patients exposed to TNF inhibitors, expected as well as observed numbers of serious infections were 3.0 per 100 patient-years (PY). For patients on non-biological DMARDs the expected and observed numbers were 1.5/100 PY and 1.8/100 PY, respectively. The score was highly predictive in groups of patients with low as well as with high infection risk. Conclusions The RABBIT Risk Score is a reliable instrument which determines the risk of serious infection in individual patients based on clinical and treatment information. It helps the rheumatologist to balance benefits and risks of treatment, to avoid high-risk treatment combinations and thus to make informed clinical decisions.This publication has 10 references indexed in Scilit:
- Use of a disease risk score to compare serious infections associated with anti–tumor necrosis factor therapy among high‐ versus lower‐risk rheumatoid arthritis patientsArthritis Care & Research, 2012
- Development and validation of a risk score for serious infection in patients with rheumatoid arthritisArthritis & Rheumatism, 2012
- Treatment benefit or survival of the fittest: what drives the time-dependent decrease in serious infection rates under TNF inhibition and what does this imply for the individual patient?Annals Of The Rheumatic Diseases, 2011
- Anti-TNF therapy is associated with an increased risk of serious infections in patients with rheumatoid arthritis especially in the first 6 months of treatment: updated results from the British Society for Rheumatology Biologics Register with special emphasis on risks in the elderlyRheumatology, 2010
- Infectious Complications of Biologic AgentsRheumatic Disease Clinics of North America, 2009
- The safety of anti-tumour necrosis factor treatments in rheumatoid arthritis: meta and exposure-adjusted pooled analyses of serious adverse eventsAnnals Of The Rheumatic Diseases, 2008
- Time-dependent increase in risk of hospitalisation with infection among Swedish RA patients treated with TNF antagonistsAnnals Of The Rheumatic Diseases, 2007
- Anti-TNF Antibody Therapy in Rheumatoid Arthritis and the Risk of Serious Infections and MalignanciesJAMA, 2006
- Predictors of infection in rheumatoid arthritisArthritis & Rheumatism, 2002
- Vergleichende Evaluation einer deutschen Version des Health Assessment Questionnaires (HAQ) und des Funktionsfragebogens Hannover (FFbH) (Comparative evaluation of a German version of the Health Assessment Questionnaire (HAQ) and the Hannover Functional Ability Questionnaire (HFAQ))Zeitschrift für Rheumatologie, 1997