Comparison of the frequency of neoplasms and infections be tween pa tients with rheuma toid arthritis and osteoar thritis

Dražen Bedeković, Ivica Bošnjak, Damir Kirner,Višnja Prus, Srđan Novak

Introduction: We compared the frequency of malignant diseases and infections between patients with RA and osteoarthritis (OA ) over an eight-year follow-up period. Subjects and methods: The study was conducted as a prospective clinical observational cohort study between 2008 and 2017. The examined group included RA patients, whereas the control group was comprised of OA patients. The total number of participants included in the research was 201; 124 participants with RA and 77 participants with OA . We analysed the data collected over the eight-year follow-up period through prepared visit protocols, as well as other sources. Results: Out of the total of 201 participants included in the study, 124 were RA patients and 77 were OA patients. A total of 137 participants, 82 patients with RA and 55 patients with OA , completed the study, and 58 participants died. Moreover, 6 patients refused to participate in the study, or their
contact info was lost (one participant with RA and five participants with OA ). There was no statistically significant difference in the frequency of neoplasms between the groups, and the most common sites of neoplasms were the lungs, breasts, and kidneys. Fifteen participants with RA (12.19%) had severe infections, and 4 of them died due to the infection, while 5 of the 72 participants with OA had severe infections (9.09%) with no deaths recorded. Non-severe infections were experienced by 12 participants in the RA group and 10 in the OA group. There was no statistically significant difference in the frequency of severe or minor infections between the studied groups. There was a statistical association between the use of anti-TNF therapy and the frequency of minor infections, while the association of the use of anti-TNF therapy with the frequency of severe infections and the frequency of neoplasms was not proven. Conclusion: Although there was no statistically significant difference in the frequency of neoplasms, RA patients had a higher mortality rate. Severe infectious diseases did not play a significant role in morbidity and mortality in both groups.

Uvod: U ovom istraživanju provedena je usporedba učestalosti malignih bolesti i infekcija između bolesnika s reumatoidnim artritisom (RA ) i osteoartritisom (OA ) tijekom osmogodišnjeg razdoblja praćenja. Ispitanici i metode: Istraživanje je provedeno kao prospektivna klinička opservacijska kohortna studija u razdoblju od 2008. do 2017. godine. Ispitivanu skupinu činili su bolesnici oboljeli od RA , a kontrolnu skupinu oboljeli od OA . Ukupan broj ispitanika uključenih u istraživanje bio je 201, od čega 124 ispitanika s RA i 77 ispitanika s OA . U istraživanju smo se koristili podatcima prikupljenim tijekom osmogodišnjeg praćenja putem pripremljenih protokola na vizitama, kao i drugim izvorima. Rezultati: Od 201 ispitanika koji su nakon probira uključeni u istraživanje, bilo je 124 oboljelih od RA i 77 oboljelih od OA , ukupno 137 ispitanika; 82 oboljelih od RA i 55 oboljelih od OA završilo je istraživanje, 58 ispitanika je preminulo, dok je šest ispitanika odbilo sudjelovanje tijekom istraživanja ili su izgubljeni kontakti (jedan s RA i pet s OA ). Ne postoji statistički značajna razlika u incidenciji neoplazme između skupina, a najčešće lokalizacije neoplazmi bile su pluća, dojka i bubrezi. Teške infekcije ispitanika s RA imalo je petnaest ispitanika (12,19%) od kojih je četvero preminulo od posljedica infekcije, dok je od 72 ispitanika s OA petero imalo teške infekcije (9,09%) bez preminulih. Lakše infekcije u skupini RA imalo je dvanaest ispitanika i deset u skupini OA . Ne postoji statistički značajna razlika u učestalosti teških infekcija između ispitivanih skupina, niti lakših infekcija. Postoji statistička povezanost između primjene anti-TNF terapije i učestalosti lakših infekcija, dok povezanost primjene anti-TNF terapije s učestalošću teških infekcija i neoplazmi nije dokazana. Zaključak: Iako nije bilo statistički značajne razlike u incidenciji neoplazmi, bolesnici s RA su imali višu smrtnost. Teške infektivne bolesti nisu imale značajniju ulogu u obolijevanju i smrtnosti u obje skupine.