Most Read Articles
13 Aug 2019
Individuals with obesity are at an elevated risk of developing infections, particularly that of the skin in both men and women, and those of the gastrointestinal and urinary tracts and sepsis in women only, according to a study.
5 days ago
An increase in intensive care unit (ICU) management and bacterial pneumonia development occurs in children with special risk medical conditions (SRMC), but a rise in the probability of death or need for mechanical ventilation remains inconsistent, suggests a recent study.
Pearl Toh, 30 Aug 2019
Oral amoxicillin–clavulanate effectively promotes resolution of nonsevere acute exacerbations in children with non-cystic fibrosis (CF) bronchiectasis, thus confirming the role of amoxicillin–clavulanate as first-line treatment for bronchiectasis, according to results from the three-arm BEST-1 study.

Risks for infections after arthroplasty similar across biologics

06 Jun 2019

Various biologic medications used prior to total knee or hip arthroplasty demonstrate similar risks for hospitalized infection, prosthetic joint infection (PJI) and readmission after surgery, reports a study. In contrast, glucocorticoids, particularly with dosages >10 mg/d, yield a greater risk for adverse outcomes.

Overall, 10,923 surgical procedures were performed in 9,911 patients treated with biologics. Patients who received different biologics showed comparable outcomes.

Compared with a risk of 8.16 percent for hospitalized infection with abatacept, propensity-weighted models revealed a predicted risk ranging from 6.87 percent (95 percent CI, 5.30–8.90 percent) with adalimumab to 8.90 percent (5.70–13.52 percent) with rituximab. Compared with a 2.14-percent 1-year cumulative incidence of PJI with abatacept, predicted incidence with rituximab and tocilizumab ranged from 0.35 percent (0.11–1.12 percent) to 3.67 percent (1.69–7.88 percent), respectively.

Glucocorticoid use correlated with a dose-dependent increase in postoperative risk for all outcomes. Predicted risk for hospitalized infection from propensity-weighted models with use of glucocorticoid >10mg/d was 13.25 percent (9.72–17.81 percent; 6.78 percent for no glucocorticoid use), while predicted 1-year cumulative PJI incidence was 3.83 percent (2.13–6.87 percent; 2.09 percent for no glucocorticoid use).

This retrospective cohort study obtained Medicare and Truven MarketScan administrative data from January 2006 through September 2015. Participants included adults with rheumatoid arthritis who were having elective inpatient total knee or hip arthroplasty, either primary or revision, and received abatacept, adalimumab, etanercept, infliximab, rituximab or tocilizumab prior to surgery.

The authors performed propensity-adjusted analyses using inverse probability weights to assess comparative risks for hospitalized infection within 30 days and PJI within 1 year after surgery between biologics or with different dosages of glucocorticoids. Secondary analyses evaluated nonurinary tract hospitalized infections and 30-day readmissions.

Some limitations included a possible residual confounding and small sample sizes for rituximab and tocilizumab, according to the authors.

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Most Read Articles
13 Aug 2019
Individuals with obesity are at an elevated risk of developing infections, particularly that of the skin in both men and women, and those of the gastrointestinal and urinary tracts and sepsis in women only, according to a study.
5 days ago
An increase in intensive care unit (ICU) management and bacterial pneumonia development occurs in children with special risk medical conditions (SRMC), but a rise in the probability of death or need for mechanical ventilation remains inconsistent, suggests a recent study.
Pearl Toh, 30 Aug 2019
Oral amoxicillin–clavulanate effectively promotes resolution of nonsevere acute exacerbations in children with non-cystic fibrosis (CF) bronchiectasis, thus confirming the role of amoxicillin–clavulanate as first-line treatment for bronchiectasis, according to results from the three-arm BEST-1 study.