{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:47:35Z","timestamp":1790606855896,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2002,9,27]],"date-time":"2002-09-27T00:00:00Z","timestamp":1033084800000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Patients with rheumatoid arthritis (RA) have been shown to have an increased susceptibility to the development of infections. The exact causes of this increased risk are unknown, but may relate to immunologic disturbances associated with the disease or to the immunosuppressive effects of agents used in its treatment. This study was undertaken to identify predictors of serious infections among patients with RA. Identification of such factors is the necessary first step in reducing the excess risk of infection in RA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Members of a population\u2010based incidence cohort of Rochester, Minnesota residents ages \u226518 years, who had been diagnosed with RA between 1955 and 1994, were followed up longitudinally through their complete medical records until January 1, 2000. We examined potential risk factors for the development of all objectively confirmed (by microbiology or radiology) infections and for infections requiring hospitalization. Potential risk factors included RA severity measures (rheumatoid factor positivity, elevated erythrocyte sedimentation rate, extraarticular manifestations of RA, and functional status), comorbidities (diabetes mellitus, alcoholism, and chronic lung disease), and other risk factors for infection (presence of leukopenia, smoking). Predictors were identified using multivariate time\u2010dependent Cox proportional hazards modeling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 609 RA patients in the cohort had a total followup time of 7,729.7 person\u2010years (mean 12.7 years per patient). A total of 389 patients (64%) had at least 1 infection with objective confirmation, and 290 (48%) had at least 1 infection requiring hospitalization. Increasing age, presence of extraarticular manifestations of RA, leukopenia, and comorbidities (chronic lung disease, alcoholism, organic brain disease, and diabetes mellitus), as well as use of corticosteroids, were strong predictors of infection (<jats:italic>P<\/jats:italic> &lt; 0.004) in both univariate and multivariate analyses. Notably, use of disease\u2010modifying antirheumatic drugs was not associated with increased risk of infection in multivariate analyses, after adjustment for demographic characteristics, comorbidities, and disease\u2010related variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We identified a number of strong predictors of infections in a population\u2010based cohort of patients with RA. These results can be used to prospectively identify high\u2010risk patients, who may benefit from closer followup and implementation of preventive strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.10529","type":"journal-article","created":{"date-parts":[[2002,10,9]],"date-time":"2002-10-09T04:45:25Z","timestamp":1034138725000},"page":"2294-2300","source":"Crossref","is-referenced-by-count":469,"title":["Predictors of infection in rheumatoid arthritis"],"prefix":"10.1002","volume":"46","author":[{"given":"Michele F.","family":"Doran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia S.","family":"Crowson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory R.","family":"Pond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Michael","family":"O'Fallon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherine E.","family":"Gabriel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,9,27]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.4065\/76.6.653"},{"key":"e_1_2_6_3_2","first-page":"S2857","article-title":"Postlicensure reports of infection during use of etanercept and infliximab","volume":"43","author":"Gershon S","year":"2000","journal-title":"Arthritis Rheum"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011110"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/art1.10243"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780381215"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.10524"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.4065\/71.3.266"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/scientificamerican1081-54"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3294-8"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.95.24.14447"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.97.16.9203"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912163412507"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/rmed.1999.0743"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1995.00430150137014"},{"key":"e_1_2_6_17_2","first-page":"227","article-title":"Pneumococcal pneumonia: epidemiology and clinical features","volume":"14","author":"Marrie TJ","year":"1999","journal-title":"Semin Respir Infect"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90131-7"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310513"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780210107"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/11.6.954"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.53.4.224"},{"key":"e_1_2_6_23_2","first-page":"188","article-title":"Toxicity profiles of disease modifying antirheumatic drugs in rheumatoid arthritis","volume":"18","author":"Singh G","year":"1991","journal-title":"J Rheumatol"},{"issue":"4","key":"e_1_2_6_24_2","first-page":"S60","article-title":"Toxicity of chronic therapy with pulse methotrexate in rheumatoid arthritis: potential increased risk of infection","volume":"30","author":"Andersen PA","year":"1987","journal-title":"Arthritis Rheum"},{"issue":"9","key":"e_1_2_6_25_2","first-page":"S242","article-title":"Serious infections in rheumatoid arthritis: relationship to immunosuppressant use","volume":"42","author":"Singh G","year":"1999","journal-title":"Arthritis Rheum"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(95)80009-3"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-857X(05)70327-6"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-857X(05)70368-9"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1949.02900430001001"}],"container-title":["Arthritis &amp; Rheumatism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fart.10529","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.10529","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T21:29:43Z","timestamp":1696973383000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/art.10529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,9]]},"references-count":28,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2002,9]]}},"alternative-id":["10.1002\/art.10529"],"URL":"https:\/\/doi.org\/10.1002\/art.10529","archive":["Portico"],"relation":{},"ISSN":["0004-3591","1529-0131"],"issn-type":[{"value":"0004-3591","type":"print"},{"value":"1529-0131","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,9]]}}}