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For this case\u2013control study, data were collected in a single centre of internal medicine and included all patients who received rituximab (RTX) for SAID between 2005 and 2011 (rheumatoid arthritis was excluded). Sixty-nine patients with SAID received a total of 87 RTX courses. Thirteen SIEs were reported in 12 patients leading to death in 5 patients. Patients with a history of SIE were significantly older (63.6\u2009\u00b1\u200918.8 vs 48.8\u2009\u00b1\u200916.7; <jats:italic>p<\/jats:italic>\u2009=\u20090.0091), suffered most frequently of diabetes mellitus (33.3\u00a0% vs 5.3\u00a0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.015), had a lower CD19 count (1.0\u2009\u00b1\u20091.2\/mm<jats:sup>3<\/jats:sup> vs 3.9\u2009\u00b1\u20097.2\/mm<jats:sup>3<\/jats:sup>) and had most frequently a prednisone dose &gt;15\u00a0mg\/day (91.7\u00a0% vs 47.7\u00a0%) at the start of the first RTX course. The SIE rate was 18.7 per 100 patient-years. At the initiation of the RTX course, risk factors for SIEs were lower IgG levels (OR\u2009=\u20090.87, 95%CI\u2009=\u20090.77\u20130.99, <jats:italic>p<\/jats:italic>\u2009=\u20090.03), lower CD19 count (OR\u2009=\u20090.85, 95%CI\u2009=\u20090.73\u20131.00) and creatinine clearance\u2009\u2264\u200945\u00a0ml\/min (OR\u2009=\u20097.78, 95%CI\u2009=\u20091.36\u201344.38, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). Conversely history of pneumococcal vaccination significantly decreased the risk of SIEs (OR\u2009=\u20090.11, 95%CI\u2009=\u20090.03\u20130.41, <jats:italic>p<\/jats:italic>\u2009=\u20090.0009). Concomitant treatment with prednisone at a dose &gt;15\u00a0mg\/day significantly increased the SIE risk (OR\u2009=\u20098.07, 95%CI\u2009=\u20091.94\u201333.59, <jats:italic>p<\/jats:italic>\u2009=\u20090.0004). SIEs are frequent in SAID treated with RTX, particularly in patients receiving high-dose corticosteroids, in patients with renal insufficiency and in patients with low IgG levels or a low CD19 count.<\/jats:p>","DOI":"10.1007\/s10067-014-2509-2","type":"journal-article","created":{"date-parts":[[2014,2,1]],"date-time":"2014-02-01T01:07:32Z","timestamp":1391216852000},"page":"799-805","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Risk factors for severe bacterial infections in patients with systemic autoimmune diseases receiving rituximab"],"prefix":"10.1007","volume":"33","author":[{"given":"Marion","family":"Heusele","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Clerson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Guery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Lambert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Launay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Lefevre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Morell-Dubois","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e9l\u00e8ne","family":"Maillard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"No\u00e9mie","family":"Le Gouellec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Yves","family":"Hatron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Hachulla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2014,2,2]]},"reference":[{"key":"2509_CR1","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1097\/MD.0b013e318190f170","volume":"87","author":"M Ramos-Casals","year":"2008","unstructured":"Ramos-Casals M, Brito-Zer\u00f3n P, Mu\u00f1oz S, Soto MJ, Biogeas Study Group (2008) A systematic review of the off-label use of biological therapies in systemic autoimmune diseases. 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