OP0274 HOSPITALISATION FOR TUBERCULOSIS AND OTHER OPPORTUNISTIC INFECTIONS IN PATIENTS WITH INFLAMMATORY JOINT DISEASES BEFORE AND AFTER THE INTRODUCTION OF BIOLOGICAL THERAPY.

Background Over the last 20 years aggressive therapy for inflammatory joint diseases (IJD) has become standard of care following acceptance Methotrexate as anchor drug and extensive use biologic since 2003. Immunosuppression increases risk common uncommon infections (1). Objectives To compare temporal rates associated mortality hospitalisation with opportunistic (OI) (Table 1) IJD patients in Western Australia between 1985 2015. Methods All hospitalized period 1980-2015 ≥ 2 diagnostic codes rheumatoid arthritis (RA, n=8490), psoriatic (PsA, n=601), axial spondylarthritis (AS, n=1419). Overall incidence (IR) microbiologically confirmed OI (Mycobacterial, Fungal viral infections)(Table during 306.514 person were expressed per 1000 compared across by rate ratios (IRR) 95% CI. IR trend 5-year periods each analyzed least square regression (R ). Mortality ratio (MRR) was number deaths observation to same disease category without OI. Table 1. Diagnostic applied define conditions hospital discharge database. ICD9CM ICD10AM RA 714.0-714.9 M05.0-M06.9 AS 720.0 M45, M08.10-M08.19 PsA 696.0 M07.0-M07.3, L40.5 Tuberculosis 010.x-018.x A15–A19 Non-tuberculous mycobacteria 031.x A30-A31 Cryptococcosis 117.5 B45 Aspergillosis 117.3 B44 Histoplasmosis 115 B39 mycosis 114.0 - 118.9 B35.0 B49.9 Pneumocystosis 136.3 B59 Cytomegaloviral 078.5 B25 Influenza 487.x, 488.x J09, J10 Herpes zoster 053.x B02 Varicella 052.x B01 Results The all (5.19, CI 4.8-5.6) significantly higher than (IRR 0.56, 0.41-0.76 0.64, 0.53-0.79) lower IRR observed especially tuberculosis H Zoster (0,49 0,47) (0,43 0,49). Zoster, TBC other most frequent cause cryptococcal pneumocystis only seen RA. decreased over time 0.51, p=0.08), 0.47, p=0.09) while H. 0.46, (Figure 1). In-hospital 4.9 % RA, 2.6 2.2% AS, but MRR (1.15; 0.71-1.97), (1.64; 0.82-3.57) (1.35; 0.68-2.89) not increased. Figure Incidence personyears patients. Conclusion hospitalization is twice high Admission including have two decades where more intensive treatment became care. This suggests efficacy preventative measures. Hospital admission a moderate death, did incur death medical complications References [1]Wang D, Yeo AL, Dendle C, Morton S, Morand E, Leech M. Severe remain real-world cohort: A simple clinical model predict infection risk. Eur J Rheumatol 2021; 8(3): 133-8. Acknowledgements Supported an unrestricted grant from Arthritis Foundation Australia. Disclosure Interests None declared