Infection Rates in Psoriatic Arthritis Patients on Biologics Have Decreased Save

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows significant decreases in infections among people with psoriatic arthritis over the years 2012-2017. (Abstract #1783). This poster will be presented on Tuesday, November 8th during the Poster Session entitled: Spondyloarthritis Including PsA – Diagnosis, Manifestations, & Outcomes Poster IV: Clinical Aspects of PsA Peripheral SpA (1773–1800)

Psoriatic arthritis is a type of inflammatory arthritis that occurs in some patients with psoriasis. This particular arthritis can affect any joint in the body, and symptoms vary from person to person. Persistent inflammation from psoriatic arthritis can lead to joint damage.

Biologic therapies now available to treat psoriatic  arthritis  (PsA)  can  help  control  disease activity and  prevent  damage,  but  these  medications  increase infection  risk.  Since  use of  biologics  to treat  PsA  has  increased  in  recent  years,  researchers  conducted this  study  to  find  out  if infections  had  increased  among  these  patients.  Researchers  looked  at  national  trends  in serious  infections  in  people with  PsA  from  2012  to 2017 across  the U.S  using  the national inpatient  sample. 

“The study  was  conducted  to  gather  data  to help  providers  have  informed  discussions  with  their patients.  Some  patients  are initially  hesitant  to  start  immunosuppressive agents  for  treatment and  understanding  this  information  can provide a  clearer  idea  of  how  this  risk  of  infection is translated  in  real  life  and  helps  differentiate  the  risk  of  minor  infections  from  serious  infections  in this  subset  of  patients,”  says  Vagishwari  Murugesan,  MD,  Senior  Rheumatology  Clinical  and Research  Fellow  at  Boston  University  Medical  Center  and  the  study’s  co-author.

Researchers used  data from  the National  Inpatient  Sample,  which  includes  a  sample  of discharge  information  from  community  hospitals,  excluding  rehabilitation  and  long-term  acute care facilities,  and  contains  about  seven  million  discharge  records.  They  identified  discharges with  a  PsA  diagnosis  with  a  principal  or  secondary  diagnosis  of  serious  infections:  pneumonia, sepsis,  urinary  tract  infection  (UTI),  and/or  skin  and  soft-tissue  infections  using  ICD-9  and  ICD10  diagnostic  codes.  They  standardized  results  for  2012-2017  to  match age  distributions  in the U.S.  population  in  2012.  Then,  they  tested  for  trends  over  the  years  2012-2017  to measure  any increases  in  these  serious  infections.

In 2012,  they  found  a  total  of  50,700  hospital  discharge  diagnoses  of  PsA,  including  125 patients  diagnosed with pneumonia,  230  patients  with  sepsis,  312 with  a  skin  or  soft-tissue infection,  and  174  with  a  UTI.  In  2017,  there  were  179,400  discharge  diagnoses  of  PsA,  with 344  patients  diagnosed with  pneumonia,  374  with sepsis,  681  with  skin  and  soft-tissue  infection, and  348 with  a  UTI.  From  2012-2017,  there  were statistically  significant  drops  in  hospital discharges  for  sepsis,  skin  and  soft-tissue  infections  and  UTI  when  standardized  for  age,  but  no statistical  differences  in  pneumonia  trends.

“While the  National  Inpatient  Sample does  not  have information  on individual  treatment  for patients  in  the  study,  the  data show  a  decrease  in  hospital  discharges  for  sepsis,  skin  and  softtissue infections,  and UTI  over  the  past  several  years.  This  information  may  help  guide  patients to make decisions  regarding  the management  of  their  arthritis  while  understanding  their infection risk,”  says  Dr.  Murugesan.