Risk of severe infection associated with immunoglobulin deficiency under rituximab therapy in immune-mediated inflammatory disease
Main finding · Severe infection, Ig deficiency (acquired or prevalent) vs normalResult — go to the resultAdjusted hazard ratio 1.04 95% CI 0.5–2.3Authors' conclusion
Risk of severe infection was not associated with RTX-induced Ig deficiency in patients with an IMID.
Study context
- Population
- Patients with an immune-mediated inflammatory disease (IMID) treated with at least one rituximab (RTX) infusion until 31 May 2020, single centre; followed up ≥12 months after last infusion or until severe infection or death
- Participants
- 311 patients
- Exposure
- Ig deficiency vs normal Ig level under RTX
- Outcome
- Severe infection
Methodological detailsobservational, single-centre, time-dependent analysis
- Observational
- Single-centre
- Time-dependent analysis
Main finding
As reported in the abstract
Severe infection, Ig deficiency (acquired or prevalent) vs normal
Adjusted hazard ratio
1.04
95% CI 0.5–2.3
P = 0.92
Ig deficiency (acquired or prevalent)vs Normal Ig level
aHR 1.04 (95% CI 0.5–2.3); P = 0.92
Observational data: associations, not effects.
Further findings
| Outcome | Prevalent Ig deficiency | Acquired Ig deficiency |
|---|---|---|
| Prevalence of Ig deficiency | 10.6% | 19.6% |
Severe infection during follow-up, overall
- Overall severe infection
- 14.5%
- Numerically but not statistically more frequent with prevalent Ig deficiency than normal Ig level
Risk factors for severe infection (multivariate analysis)
- Associated with chronic pulmonary disease, GC dose and mean DAS28-CRP
Factors related to Ig deficiency
- Prevalent Ig deficiency related to concomitant glucocorticoids (GCs), in particular high daily dose at baseline
- Acquired Ig deficiency related to cumulative RTX dose, mean DAS28, immunosuppressor or GC therapy at baseline, diabetes mellitus and obesity
Original publication
Risk of severe infection associated with immunoglobulin deficiency under rituximab therapy in immune-mediated inflammatory disease. RMD Open. Published 30 January 2024. doi:10.
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