Undetectable Mannose Binding Lectin and Corticosteroids Increase Serious Infection Risk in Rheumatoid Arthritis Graeme J. Carroll, MD, Krista Makin,

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Presentation transcript:

Undetectable Mannose Binding Lectin and Corticosteroids Increase Serious Infection Risk in Rheumatoid Arthritis Graeme J. Carroll, MD, Krista Makin, MBBS, Maxine Garnsey, MBBS, Max Bulsara, PhD, Bronwyn V. Carroll, MBBS, Shona M. Curtin, MBBS, Erin M. Allan, BEng, Andrew McLean-Tooke, MD, Christine Bundell, PhD, Monica L. Kemp, MSc, Pooja Deshpande, MSc, Dana Ihdayhid, MBBS, Sophie Coleman, PhD, Tracie Easter, MSc, James Triplett, MMed, Timothy Disteldorf, MBBS, C. Helen Marsden, MSc, Michaela Lucas, MD The Journal of Allergy and Clinical Immunology: In Practice Volume 5, Issue 6, Pages 1609-1616 (November 2017) DOI: 10.1016/j.jaip.2017.02.025 Copyright © 2017 The Authors Terms and Conditions

Figure 1 Correlation between the 1st and 2nd mannose binding lectin (MBL) test (n = 331). R2 = 0.81 (complete data set). The dotted lines indicate the grouping (namely <56 ng/mL and <1300 ng/mL) used in our study. The Journal of Allergy and Clinical Immunology: In Practice 2017 5, 1609-1616DOI: (10.1016/j.jaip.2017.02.025) Copyright © 2017 The Authors Terms and Conditions

Figure 2 Number of serious infections per hundred patient years according to MBL concentrations or prednisolone dose; participants treated with biologic DMARDs (n = 132) or synthetic DMARDs (n = 96). “Pred” denotes prednisolone, “Biologics” denotes biologic DMARDs, and “Non-Biologics” denotes synthetic DMARDs. DMARD, Disease-modifying antirheumatic drug; MBL, mannose binding lectin; PY, patient year. The Journal of Allergy and Clinical Immunology: In Practice 2017 5, 1609-1616DOI: (10.1016/j.jaip.2017.02.025) Copyright © 2017 The Authors Terms and Conditions

Figure 3 The incidence of serious infections (SIs) by mannose binding lectin (MBL) concentration (undetectable or detectable) and dose of prednisolone (0-5 mg and >5 mg). A much higher rate of SIs was observed in participants with undetectable MBL who were receiving a prednisolone dose >5 mg (68 per 100 patient years of treatment or observation). Statistical tests for an interaction between MBL and prednisolone did not support synergy (P = .203). The Journal of Allergy and Clinical Immunology: In Practice 2017 5, 1609-1616DOI: (10.1016/j.jaip.2017.02.025) Copyright © 2017 The Authors Terms and Conditions