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• W2553174178 abstract "<h3>Background</h3> Rheumatoid arthritis (RA) is a risk factor for septic arthritis (SA), and anti-TNF therapy doubles the risk of SA. <h3>Objectives</h3> The purpose of this study was to see whether the frequency and features of SA complicating RA have changed over the last 35 years. <h3>Methods</h3> This retrospective single-center study included the full register of all patients hospitalized at the rheumatology department of Clermont-Ferrand – CHU between 1979 and 2013 for septic arthritis bacteriologically documented by synovial fluid and/or blood culture samples. The periods 1979–2002 (period before biotherapies) and 2003–2013 (last decade in the era of biotherapies) were compared. <h3>Results</h3> Between 1979 and 2013, 64/514 (12.5%) SA presented with a RA – 21/153 (13.7%) in the 2003–2013 period and 43/361 (11.9%) in the 1979–2002 period. Over the past decade, median age of SA–RA patients increased (61 <i>vs</i> 68 years; <i>p</i><0.02) and predominant gender became males (52% <i>vs</i> 40%). The features of the RA remained unchanged: history (18 years (8–29) <i>vs</i> 16 (8–25)), rheumatoid factor (95% <i>vs</i> 87%), and corticosteroids (91% <i>vs</i> 81%) at the same mean dose (10 mg/d). 71% in the period before biotherapies and 63% in the last decade received a DMARD. Over the last decade 24% (<i>vs</i> 0; <i>p</i><0.003) of patients received a biologic DMARD: etanercept (n=2), adalimumab (n=1), rituximab (n=1), tocilizumab (n=1). Proportion of polyarticular infection had decreased (9.5% <i>vs</i> 37%; <i>p</i><0.02), down to the same level as SA-non-RA cases (8%). Proportion of <i>S. aureus</i> infections had stabilized (62% <i>vs</i> 74%) in SA-RA patients but was higher than SA-non-RA (47% and 53%). MRSA infections became more frequent in SA-RA (31% <i>vs</i> 6%; <i>p</i><0.05) in contrast to SA-non-RA cases (8% <i>vs</i> 16%; ns). Gram-negative bacilli infections have tended to become more frequent (19% <i>vs</i> 5%; <i>p</i>=0.08). Blood cultures less often tested positive (29% <i>vs</i> 47%; ns). Mortality rates has fallen slightly (5% <i>vs</i> 9%; ns), in contrast to SA-non-RA cases (7% <i>vs</i> 6%; ns). <h3>Conclusions</h3> This study brings reassuring findings – in the era of biotherapies, the frequency of septic arthritis complicating rheumatoid arthritis has stabilized, and the most severe septic polyarticular forms are on the decline. <h3>Disclosure of Interest</h3> None declared" @default.
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• W2553174178 date "2016-06-01" @default.
• W2553174178 modified "2023-09-24" @default.
• W2553174178 title "AB0352 The Changing Face of Septic Arthritis Complicating Rheumatoid Arthritis in The Era of Biotherapies. Retrospective Single-Center Study over 35 Years" @default.
• W2553174178 doi "https://doi.org/10.1136/annrheumdis-2016-eular.1983" @default.
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