Clinical characteristics of and risk factors for serious infection in Japanese patients within six months of remission induction therapy for antineutrophil cytoplasmic antibody-associated vasculitis registered in a nationwide,prospective, inception cohort study

Objectives: The purpose of this study was to identify the clinical characteristics and predictors of serious infections (SIs) in the RemIT-JAV, a nationwide, prospective, inception cohort study for Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).

Methods: We analyzed SIs within six months of remission induction therapy in 156 AAV patients. Hazard ratios with 95% confidence intervals (CIs) for SIs were calculated using the COX proportional hazard model.

Results: Sixty-three SIs in 42 patients were identified. The incidence rate (IR) of SIs was 87.59/100 patient-years. The median length of time to the onset of first SIs was 54 days. Hazard ratios (95%CI) for SIs were 1.97 (0.99–3.95) for age >65 years, 0.47 (0.25–0.89) for female sex, 2.11 (1.05–4.27) for the severe form of AAV, and 2.88 (1.49–5.88) for initial PSL >0.8?mg/kg/day in the first model, and 2.64 (1.39–5.01) for smoking and 3.27 (1.66–6.45) for initial PSL >0.8?mg/kg/day in the second model.

Conclusions: Lowering the IR of SIs in Japanese AAV patients is mandatory to improve the vital prognosis of these patients. For remission induction therapy of AAV patients with these risk factors, risk management of immunosuppressive treatment should be carefully considered.     

慢性阻塞性肺疾病:思考与展望

慢性阻塞性肺疾病(慢阻肺)是一种常见慢性病。相比以前我们对慢阻肺的有限认识,目前研究结果表明慢阻肺的临床与生物学特征具有明显的复杂性和异质性。本文重点结合目前国际上几个大型临床队列研究结果,对慢阻肺高危人群的识别、诊断、评估及治疗方面的进展进行了阐述与展望。