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Patients with RA at increased risk for COVID-19
Key clinical point: Compared with the general population, the risk for COVID-19 was significantly higher in patients with rheumatoid arthritis (RA) but not in those with osteoarthritis, supporting recommendations for booster vaccines and priority access to anti-SARS-CoV-2 monoclonal antibody treatment for patients with RA.
Major finding: Compared with the general population, the risk for suspected/confirmed COVID-19 was significantly higher in patients with RA (hazard ratio [HR] 1.19; 95% CI 1.04-1.36) but not in patients with osteoarthritis (HR 1.00; 95% CI 0.93-1.07).
Study details: This was a cohort analysis that compared the risk for COVID-19 among 17,268 patients with RA and 1,616,600 participants from the general population.
Disclosures: This work was supported by the National Natural Science Foundation of China, the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), and others. No conflict of interests was reported.
Source: Wang Y et al. Arthritis Care Res (Hoboken). 2021 (Dec 7). Doi: 10.1002/acr.24831.
Key clinical point: Compared with the general population, the risk for COVID-19 was significantly higher in patients with rheumatoid arthritis (RA) but not in those with osteoarthritis, supporting recommendations for booster vaccines and priority access to anti-SARS-CoV-2 monoclonal antibody treatment for patients with RA.
Major finding: Compared with the general population, the risk for suspected/confirmed COVID-19 was significantly higher in patients with RA (hazard ratio [HR] 1.19; 95% CI 1.04-1.36) but not in patients with osteoarthritis (HR 1.00; 95% CI 0.93-1.07).
Study details: This was a cohort analysis that compared the risk for COVID-19 among 17,268 patients with RA and 1,616,600 participants from the general population.
Disclosures: This work was supported by the National Natural Science Foundation of China, the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), and others. No conflict of interests was reported.
Source: Wang Y et al. Arthritis Care Res (Hoboken). 2021 (Dec 7). Doi: 10.1002/acr.24831.
Key clinical point: Compared with the general population, the risk for COVID-19 was significantly higher in patients with rheumatoid arthritis (RA) but not in those with osteoarthritis, supporting recommendations for booster vaccines and priority access to anti-SARS-CoV-2 monoclonal antibody treatment for patients with RA.
Major finding: Compared with the general population, the risk for suspected/confirmed COVID-19 was significantly higher in patients with RA (hazard ratio [HR] 1.19; 95% CI 1.04-1.36) but not in patients with osteoarthritis (HR 1.00; 95% CI 0.93-1.07).
Study details: This was a cohort analysis that compared the risk for COVID-19 among 17,268 patients with RA and 1,616,600 participants from the general population.
Disclosures: This work was supported by the National Natural Science Foundation of China, the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), and others. No conflict of interests was reported.
Source: Wang Y et al. Arthritis Care Res (Hoboken). 2021 (Dec 7). Doi: 10.1002/acr.24831.
High disease activity during pregnancy tied to adverse pregnancy outcomes in RA
Key clinical point: The risk for preterm birth (PTB) and small for gestational age (SGA) is almost 2-fold higher in pregnant women with vs. without rheumatoid arthritis (RA), with high maternal RA disease activity during pregnancy being a significant risk factor.
Major finding: The risk for PTB (adjusted odds ratio [aOR] 1.92; 95% CI 1.56-2.35) and SGA (aOR 1.93; 95% CI 1.45-2.57) was significantly higher in RA pregnancies vs. control pregnancies, with the risk even higher with maternal Disease Activity Score in 28 joints-C-reactive protein of >4.1 vs. <3.2 during pregnancy (PTB: aOR 3.38; 95% CI 1.52-7.55; SGA: aOR 3.90; 95% CI 1.46-10.4).
Study details: This was a prospective cohort study of 1,739 RA-pregnancies matched with 17,390 control-pregnancies.
Disclosures: This study was supported by NordForsk and others. Some of the authors declared receiving consultancy fees, research grants, and serving on the steering committee for various sources.
Source: Hellgren K et al. Rheumatology (Oxford). 2021;keab894 (Dec 3). Doi: 10.1093/rheumatology/keab894.
Key clinical point: The risk for preterm birth (PTB) and small for gestational age (SGA) is almost 2-fold higher in pregnant women with vs. without rheumatoid arthritis (RA), with high maternal RA disease activity during pregnancy being a significant risk factor.
Major finding: The risk for PTB (adjusted odds ratio [aOR] 1.92; 95% CI 1.56-2.35) and SGA (aOR 1.93; 95% CI 1.45-2.57) was significantly higher in RA pregnancies vs. control pregnancies, with the risk even higher with maternal Disease Activity Score in 28 joints-C-reactive protein of >4.1 vs. <3.2 during pregnancy (PTB: aOR 3.38; 95% CI 1.52-7.55; SGA: aOR 3.90; 95% CI 1.46-10.4).
Study details: This was a prospective cohort study of 1,739 RA-pregnancies matched with 17,390 control-pregnancies.
Disclosures: This study was supported by NordForsk and others. Some of the authors declared receiving consultancy fees, research grants, and serving on the steering committee for various sources.
Source: Hellgren K et al. Rheumatology (Oxford). 2021;keab894 (Dec 3). Doi: 10.1093/rheumatology/keab894.
Key clinical point: The risk for preterm birth (PTB) and small for gestational age (SGA) is almost 2-fold higher in pregnant women with vs. without rheumatoid arthritis (RA), with high maternal RA disease activity during pregnancy being a significant risk factor.
Major finding: The risk for PTB (adjusted odds ratio [aOR] 1.92; 95% CI 1.56-2.35) and SGA (aOR 1.93; 95% CI 1.45-2.57) was significantly higher in RA pregnancies vs. control pregnancies, with the risk even higher with maternal Disease Activity Score in 28 joints-C-reactive protein of >4.1 vs. <3.2 during pregnancy (PTB: aOR 3.38; 95% CI 1.52-7.55; SGA: aOR 3.90; 95% CI 1.46-10.4).
Study details: This was a prospective cohort study of 1,739 RA-pregnancies matched with 17,390 control-pregnancies.
Disclosures: This study was supported by NordForsk and others. Some of the authors declared receiving consultancy fees, research grants, and serving on the steering committee for various sources.
Source: Hellgren K et al. Rheumatology (Oxford). 2021;keab894 (Dec 3). Doi: 10.1093/rheumatology/keab894.
Factors predicting response to TNF inhibitors in RA
Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.
Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m2 (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).
Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.
Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.
Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.
Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.
Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m2 (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).
Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.
Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.
Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.
Key clinical point: Patients with rheumatoid arthritis (RA) who are not obese, those who have high initial disease activity, and those with long disease duration are more responsive to tumor necrosis factor (TNF) inhibitors.
Major finding: The risk for European League Against Rheumatism nonresponse was significantly higher in patients with obesity vs. those with a body mass index of <30 kg/m2 (odds ratio 0.52 vs. 0.36; P = .01). Among patients treated with TNF inhibitors, the final Disease Activity Score on 28 joints-C-reactive protein (DAS28-CRP) decreased by 0.02 each year of disease duration (P < .001), with a reduction of 0.21 in patients with a baseline DAS28-CRP of >5.1 (P = .05).
Study details: This was a pooled analysis of individual patient data of 11,617 patients with RA from 29 randomized controlled trials.
Disclosures: This work was partly supported by the French Higher Education and Research Ministry. P Goupille and D Mulleman declared serving as a consultant or speaker, participating in international congresses or clinical trials, and receiving grants from various sources.
Source: Law-Wan J et al. RMD Open. 2021;7(3):e001882 (Nov 17). Doi: 10.1136/rmdopen-2021-001882.
RA patients treated with JAK inhibitors may need additional BNT162b2 COVID-19 vaccine boosts
Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.
Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.
Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.
Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.
Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi: 10.1093/rheumatology/keab879.
Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.
Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.
Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.
Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.
Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi: 10.1093/rheumatology/keab879.
Key clinical point: Patients with rheumatoid arthritis (RA) who were treated with Janus kinase (JAK) inhibitor showed reduced humoral response following 2 doses of BNT162b2 COVID-19 vaccine compared with healthy individuals.
Major finding: Patients with RA treated with JAK inhibitors had significantly lower levels of anti-spike immunoglobulin G antibodies (P = .024) than healthy individuals.
Study details: This study involved 12 adult patients with RA treated with JAK inhibitors and 26 healthy individuals who received 2 doses of the BNT162b2 COVID-19 vaccine.
Disclosures: This work was funded by the ISF Corona grant. The authors declared no conflict of interests.
Source: Iancovici L et al. Rheumatology (Oxford). 2021:keab879 (Nov 25). Doi: 10.1093/rheumatology/keab879.
Not all patients with community-acquired pneumonia respond to adjunctive dexamethasone
Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.
Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).
Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.
Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.
Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.
Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.
Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).
Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.
Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.
Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.
Key clinical point: Neutrophil count, white blood cell (WBC) count, or neutrophil-lymphocyte ratio (NLR) may help in ascertaining which patients hospitalized for community-acquired pneumonia (CAP) would benefit from adjunctive oral dexamethasone therapy.
Main finding: Among patients with a high neutrophil count, WBC count, or NLR who did not die in hospital, those who received dexamethasone had a shorter median length of stay (LOS) than those who received placebo (4 days vs. 6 days), whereas patients with low values for these parameters showed no difference in LOS between those receiving placebo and dexamethasone (P < .05).
Study details: Findings are from a post hoc analysis on 354 out of the 401 non-ICU patients with CAP included in the randomized placebo-controlled Santeon-CAP trial who were randomly assigned to receive either placebo or oral dexamethasone.
Disclosures: The study was sponsored by St. Antonius research fund. The authors declared no conflicts of interests.
Source: Wittermans E et al. Eur J Intern Med. 2021 (Nov 12). Doi: 10.1016/j.ejim.2021.10.030.
Serum IL-17 may aid in predicting the prognosis of community-acquired pneumonia
Key clinical point: Serum IL-17 levels show a positive correlation with the severity and poor prognostic outcomes in patients with community-acquired pneumonia (CAP).
Main finding: In patients with CAP, serum IL-17 levels at admission increased in parallel with CAP severity scores, such as pneumonia severity index, and, after adjusting for confounding factors, showed a positive correlation with intensive care unit (ICU) admission (adjusted odds ratio [aOR] 1.01; P = .01), mechanical ventilation (aOR 1.10; P = .02), death (aOR, 1.05; P < .01), and hospital stay of 14 days or more (aOR 1.21; P = .01).
Study details: This was a prospective cohort study including 239 patients who were hospitalized for CAP.
Disclosures: The National Natural Science Foundation of China, Anhui Provincial Natural Science Foundation, National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University, and Scientific Research of Health Commission in Anhui Province sponsored the study. None of the authors declared any conflict of interests.
Source: Feng CM et al. BMC Pulm Med. 2021;21:393 (Dec 2). Doi: 10.1186/s12890-021-01770-6.
Key clinical point: Serum IL-17 levels show a positive correlation with the severity and poor prognostic outcomes in patients with community-acquired pneumonia (CAP).
Main finding: In patients with CAP, serum IL-17 levels at admission increased in parallel with CAP severity scores, such as pneumonia severity index, and, after adjusting for confounding factors, showed a positive correlation with intensive care unit (ICU) admission (adjusted odds ratio [aOR] 1.01; P = .01), mechanical ventilation (aOR 1.10; P = .02), death (aOR, 1.05; P < .01), and hospital stay of 14 days or more (aOR 1.21; P = .01).
Study details: This was a prospective cohort study including 239 patients who were hospitalized for CAP.
Disclosures: The National Natural Science Foundation of China, Anhui Provincial Natural Science Foundation, National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University, and Scientific Research of Health Commission in Anhui Province sponsored the study. None of the authors declared any conflict of interests.
Source: Feng CM et al. BMC Pulm Med. 2021;21:393 (Dec 2). Doi: 10.1186/s12890-021-01770-6.
Key clinical point: Serum IL-17 levels show a positive correlation with the severity and poor prognostic outcomes in patients with community-acquired pneumonia (CAP).
Main finding: In patients with CAP, serum IL-17 levels at admission increased in parallel with CAP severity scores, such as pneumonia severity index, and, after adjusting for confounding factors, showed a positive correlation with intensive care unit (ICU) admission (adjusted odds ratio [aOR] 1.01; P = .01), mechanical ventilation (aOR 1.10; P = .02), death (aOR, 1.05; P < .01), and hospital stay of 14 days or more (aOR 1.21; P = .01).
Study details: This was a prospective cohort study including 239 patients who were hospitalized for CAP.
Disclosures: The National Natural Science Foundation of China, Anhui Provincial Natural Science Foundation, National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University, and Scientific Research of Health Commission in Anhui Province sponsored the study. None of the authors declared any conflict of interests.
Source: Feng CM et al. BMC Pulm Med. 2021;21:393 (Dec 2). Doi: 10.1186/s12890-021-01770-6.
Antibiotics posing minimal AKI risk in community-acquired pneumonia
Key clinical point: In patients hospitalized for community-acquired pneumonia (CAP), the least risk of acute kidney injury (AKI) can be achieved by empiric treatment with a third-generation cephalosporin ± macrolide or a respiratory fluoroquinolone.
Main finding: Barring fluoroquinolones (adjusted odds ratio [aOR] 1.06; 95% CI 0.98-1.14), all regimens offered a higher risk for AKI than a third-generation cephalosporin ± macrolide, with piperacillin/tazobactam + vancomycin being associated with the highest AKI odds (aOR 1.89; 95% CI 1.73-2.06).
Study details: Findings are from a retrospective cohort study consisting of 449,535 adult patients hospitalized for CAP, of whom 3.1% developed AKI.
Disclosures: The study was sponsored by the Agency for Healthcare Research and Quality. The authors declared no conflict of interests.
Source: Le P et al. Curr Med Res Opin. 2021 (Nov 15). Doi: 10.1080/03007995.2021.2000716.
Key clinical point: In patients hospitalized for community-acquired pneumonia (CAP), the least risk of acute kidney injury (AKI) can be achieved by empiric treatment with a third-generation cephalosporin ± macrolide or a respiratory fluoroquinolone.
Main finding: Barring fluoroquinolones (adjusted odds ratio [aOR] 1.06; 95% CI 0.98-1.14), all regimens offered a higher risk for AKI than a third-generation cephalosporin ± macrolide, with piperacillin/tazobactam + vancomycin being associated with the highest AKI odds (aOR 1.89; 95% CI 1.73-2.06).
Study details: Findings are from a retrospective cohort study consisting of 449,535 adult patients hospitalized for CAP, of whom 3.1% developed AKI.
Disclosures: The study was sponsored by the Agency for Healthcare Research and Quality. The authors declared no conflict of interests.
Source: Le P et al. Curr Med Res Opin. 2021 (Nov 15). Doi: 10.1080/03007995.2021.2000716.
Key clinical point: In patients hospitalized for community-acquired pneumonia (CAP), the least risk of acute kidney injury (AKI) can be achieved by empiric treatment with a third-generation cephalosporin ± macrolide or a respiratory fluoroquinolone.
Main finding: Barring fluoroquinolones (adjusted odds ratio [aOR] 1.06; 95% CI 0.98-1.14), all regimens offered a higher risk for AKI than a third-generation cephalosporin ± macrolide, with piperacillin/tazobactam + vancomycin being associated with the highest AKI odds (aOR 1.89; 95% CI 1.73-2.06).
Study details: Findings are from a retrospective cohort study consisting of 449,535 adult patients hospitalized for CAP, of whom 3.1% developed AKI.
Disclosures: The study was sponsored by the Agency for Healthcare Research and Quality. The authors declared no conflict of interests.
Source: Le P et al. Curr Med Res Opin. 2021 (Nov 15). Doi: 10.1080/03007995.2021.2000716.
How reliable is qSOFA in predicting mortality in community-acquired pneumonia?
Key clinical point: Quick sequential (sepsis-related) organ failure assessment (qSOFA) is better than the Infectious Disease Society of America/American Thoracic Society minor criteria and worse than confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65) in predicting mortality in community-acquired pneumonia (CAP).
Main finding: The predictive validity of qSOFA for mortality (area under the receiver operating characteristic curve [AUROC] 0.868; 95% CI 0.853-0.882) was higher than that of minor criteria (AUROC 0.824; P < .0001) and lower than that of CURB-65 (AUROC 0.919; P < .0001).
Study details: The data come from an observational prospective cohort study consisting of 2,116 adult patients with CAP.
Disclosures: The study was sponsored by the Medical Science and Technology Foundation of Guangdong Province, Planned Science and Technology Project of Shenzhen Municipality, and Nonprofit Scientific Research Project of Futian District. The authors declared no conflict of interests.
Source: Guo Q et al. Am J Emerg Med. 2022(Feb);52:1-7 (Nov 24). Doi: 10.1016/j.ajem.2021.11.029.
Key clinical point: Quick sequential (sepsis-related) organ failure assessment (qSOFA) is better than the Infectious Disease Society of America/American Thoracic Society minor criteria and worse than confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65) in predicting mortality in community-acquired pneumonia (CAP).
Main finding: The predictive validity of qSOFA for mortality (area under the receiver operating characteristic curve [AUROC] 0.868; 95% CI 0.853-0.882) was higher than that of minor criteria (AUROC 0.824; P < .0001) and lower than that of CURB-65 (AUROC 0.919; P < .0001).
Study details: The data come from an observational prospective cohort study consisting of 2,116 adult patients with CAP.
Disclosures: The study was sponsored by the Medical Science and Technology Foundation of Guangdong Province, Planned Science and Technology Project of Shenzhen Municipality, and Nonprofit Scientific Research Project of Futian District. The authors declared no conflict of interests.
Source: Guo Q et al. Am J Emerg Med. 2022(Feb);52:1-7 (Nov 24). Doi: 10.1016/j.ajem.2021.11.029.
Key clinical point: Quick sequential (sepsis-related) organ failure assessment (qSOFA) is better than the Infectious Disease Society of America/American Thoracic Society minor criteria and worse than confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65) in predicting mortality in community-acquired pneumonia (CAP).
Main finding: The predictive validity of qSOFA for mortality (area under the receiver operating characteristic curve [AUROC] 0.868; 95% CI 0.853-0.882) was higher than that of minor criteria (AUROC 0.824; P < .0001) and lower than that of CURB-65 (AUROC 0.919; P < .0001).
Study details: The data come from an observational prospective cohort study consisting of 2,116 adult patients with CAP.
Disclosures: The study was sponsored by the Medical Science and Technology Foundation of Guangdong Province, Planned Science and Technology Project of Shenzhen Municipality, and Nonprofit Scientific Research Project of Futian District. The authors declared no conflict of interests.
Source: Guo Q et al. Am J Emerg Med. 2022(Feb);52:1-7 (Nov 24). Doi: 10.1016/j.ajem.2021.11.029.
Mortality in community-acquired pneumonia is related to admission blood glucose levels
Key clinical point: A positive association exists between blood glucose levels at hospital admission for community-acquired pneumonia (CAP) and 28-day mortality, and the strength of this association decreases with age.
Main finding: After adjusting for confounding factors, all patients exhibited a significant association between blood glucose levels at hospitalization and 28-day mortality (hazard ratio [HR] 2.08; P < .01). After age stratification, this association was evidenced in both middle-aged (HR 4.48; P < .01) and elderly (HR 1.52; P = .05) patients, but was stronger in the former (P = .01).
Study details: This was a retrospective observational study including 1,656 patients aged ≥45 years who were hospitalized for CAP, of which 592 were middle-aged (45-64 years) and 1,064 were elderly (>65 years).
Disclosures: The authors declared no conflict of interests.
Source: Shen Y et al. Int J Gen Med. 2021;14:7775-7781 (Nov 6). Doi: 10.2147/IJGM.S331082.
Key clinical point: A positive association exists between blood glucose levels at hospital admission for community-acquired pneumonia (CAP) and 28-day mortality, and the strength of this association decreases with age.
Main finding: After adjusting for confounding factors, all patients exhibited a significant association between blood glucose levels at hospitalization and 28-day mortality (hazard ratio [HR] 2.08; P < .01). After age stratification, this association was evidenced in both middle-aged (HR 4.48; P < .01) and elderly (HR 1.52; P = .05) patients, but was stronger in the former (P = .01).
Study details: This was a retrospective observational study including 1,656 patients aged ≥45 years who were hospitalized for CAP, of which 592 were middle-aged (45-64 years) and 1,064 were elderly (>65 years).
Disclosures: The authors declared no conflict of interests.
Source: Shen Y et al. Int J Gen Med. 2021;14:7775-7781 (Nov 6). Doi: 10.2147/IJGM.S331082.
Key clinical point: A positive association exists between blood glucose levels at hospital admission for community-acquired pneumonia (CAP) and 28-day mortality, and the strength of this association decreases with age.
Main finding: After adjusting for confounding factors, all patients exhibited a significant association between blood glucose levels at hospitalization and 28-day mortality (hazard ratio [HR] 2.08; P < .01). After age stratification, this association was evidenced in both middle-aged (HR 4.48; P < .01) and elderly (HR 1.52; P = .05) patients, but was stronger in the former (P = .01).
Study details: This was a retrospective observational study including 1,656 patients aged ≥45 years who were hospitalized for CAP, of which 592 were middle-aged (45-64 years) and 1,064 were elderly (>65 years).
Disclosures: The authors declared no conflict of interests.
Source: Shen Y et al. Int J Gen Med. 2021;14:7775-7781 (Nov 6). Doi: 10.2147/IJGM.S331082.
Most community-acquired bacterial pneumonia-causing pathogens succumb to lefamulin
Key clinical point: Lefamulin is suitable as monotherapy against common community-acquired bacterial pneumonia (CABP)-causing pathogens, both typical and atypical, including drug-resistant strains and those causing polymicrobial infections.
Main finding: Lefamulin was as effective as moxifloxacin in the microbiological intent-to-treat (microITT) population, exhibiting a similar early clinical response rate (89.3% vs. 93.0%; difference ‒3.7; 95% CI ‒7.9 to 0.5) and investigator assessment of clinical response success rate (83.2% vs. 86.7%; difference ‒3.3; 95% CI ‒8.6 to 2.0).
Study details: The study analyzed pooled data from the phase 3 noninferiority Lefamulin Evaluation Against Pneumonia 1 and 2 trials, including a total of 1,289 adult patients with CABP (Pneumonia Outcomes Research Team risk classes II-V) who were randomly assigned to receive lefamulin or moxifloxacin. Of these, a baseline CABP pathogen was detected in 709 patients (microITT population).
Disclosures: Nabriva Therapeutics plc (Fort Washington, PA, USA) sponsored the study. Some of the authors, including the lead author, are former or current employees of or stockholders in Nabriva Therapeutics. A few others received research grants/consultation fees from various sources including Nabriva Therapeutics.
Source: Paukner S et al. J Glob Antimicrob Resist. 2021 (Nov 14). Doi: 10.1016/j.jgar.2021.10.021.
Key clinical point: Lefamulin is suitable as monotherapy against common community-acquired bacterial pneumonia (CABP)-causing pathogens, both typical and atypical, including drug-resistant strains and those causing polymicrobial infections.
Main finding: Lefamulin was as effective as moxifloxacin in the microbiological intent-to-treat (microITT) population, exhibiting a similar early clinical response rate (89.3% vs. 93.0%; difference ‒3.7; 95% CI ‒7.9 to 0.5) and investigator assessment of clinical response success rate (83.2% vs. 86.7%; difference ‒3.3; 95% CI ‒8.6 to 2.0).
Study details: The study analyzed pooled data from the phase 3 noninferiority Lefamulin Evaluation Against Pneumonia 1 and 2 trials, including a total of 1,289 adult patients with CABP (Pneumonia Outcomes Research Team risk classes II-V) who were randomly assigned to receive lefamulin or moxifloxacin. Of these, a baseline CABP pathogen was detected in 709 patients (microITT population).
Disclosures: Nabriva Therapeutics plc (Fort Washington, PA, USA) sponsored the study. Some of the authors, including the lead author, are former or current employees of or stockholders in Nabriva Therapeutics. A few others received research grants/consultation fees from various sources including Nabriva Therapeutics.
Source: Paukner S et al. J Glob Antimicrob Resist. 2021 (Nov 14). Doi: 10.1016/j.jgar.2021.10.021.
Key clinical point: Lefamulin is suitable as monotherapy against common community-acquired bacterial pneumonia (CABP)-causing pathogens, both typical and atypical, including drug-resistant strains and those causing polymicrobial infections.
Main finding: Lefamulin was as effective as moxifloxacin in the microbiological intent-to-treat (microITT) population, exhibiting a similar early clinical response rate (89.3% vs. 93.0%; difference ‒3.7; 95% CI ‒7.9 to 0.5) and investigator assessment of clinical response success rate (83.2% vs. 86.7%; difference ‒3.3; 95% CI ‒8.6 to 2.0).
Study details: The study analyzed pooled data from the phase 3 noninferiority Lefamulin Evaluation Against Pneumonia 1 and 2 trials, including a total of 1,289 adult patients with CABP (Pneumonia Outcomes Research Team risk classes II-V) who were randomly assigned to receive lefamulin or moxifloxacin. Of these, a baseline CABP pathogen was detected in 709 patients (microITT population).
Disclosures: Nabriva Therapeutics plc (Fort Washington, PA, USA) sponsored the study. Some of the authors, including the lead author, are former or current employees of or stockholders in Nabriva Therapeutics. A few others received research grants/consultation fees from various sources including Nabriva Therapeutics.
Source: Paukner S et al. J Glob Antimicrob Resist. 2021 (Nov 14). Doi: 10.1016/j.jgar.2021.10.021.