Naim Mahroum, Israel
Sheba Medical Center Department of Medicine 'B'Presenter of 1 Presentation
THE RISK OF INFECTION IN PATIENTS WITH POLYMYOSITIS AND DERMATOMYOSITIS TREATED WITH DIVERSE IMMUNOSOPRESSIVE THERAPY: A LARGE CROSS-SECTIONAL STUDY
Abstract
Background and Aims
Polymyositis and dermatomyositis (PM/DM) are chronic inflammatory diseases affecting the muscle, often require immunosuppressive therapy that may increase the risk for infections.
Methods
We utilized the CLALIT database (2,085 cases – 1,475 with DM and 610 with PM) and conducted a cross-sectional study to assess which drug conferred a higher risk of infection.
Results
At the multivariate regression analysis, adjusting for confounding factors such as age and gender, azathioprine was associated with a higher risk of developing parvovirus (OR 4.16 [95%CI 2.39-7.23]), EBV (OR 2.35 [95%CI 1.74-3.16]) and tuberculosis (OR 4.14 [95%CI 1.12-15.25]). The administration of methotrexate was associated with a higher risk of developing EBV (OR 2.09 [95%CI 1.64 to 2.66]) and VZV (OR 2.07 [95%CI 1.34 to 3.20]). The use of cyclophosphamide did not significantly impact on the risk of infections, whereas plasmapheresis conferred a higher risk of developing HCV (OR 19.83 [95%CI 2.18 to 180.71], parvovirus (OR 49.31 [95%CI 8.55 to 284.27]) and EBV (OR 5.89 [95%CI 1.27 to 27.31]). The use of rituximab resulted in a higher risk of developing HBV (OR 5.10 [95%CI 1.77 to 14.71]), parvovirus (OR 4.69 [95%CI 2.13 to 10.31]), and EBV (OR 3.84 [95%CI 2.46 to 5.98]). Finally, the use of steroids conferred a higher risk of EBV.
Conclusions
Patients with PM/ DM and mainly those treated with immunosuppressive therapy ar at higher risk of viral infections and clinicians could use these findings to properly plan the management and treatment of PM/DM patients.