Patients with systemic lupus erythematous (SLE) have a substantial burden of serious infections with many subsequent deaths, particularly among those with lupus nephritis (LN), according to a study of 33,565 patients with SLE, including 7,113 patients who also had LN. Researchers found:

• There were 9,078 serious infections in 5,078 patients with SLE, with an infection rate of 10.8 per 100 person-years.

• There were 3,494 serious infections in 1,825 LN patients, with an infection rate of 23.9 per 100 person-years.

• For increased risk of infection:

• Men had a hazard ratio (HR) of 1.33 compared to women.

• Blacks had an HR of 1.14 compared to whites.

• Users of glucocorticoids and immunosuppressive drugs had an HR of 1.51 compared to never users.

• Users of hydroxychloroquine had lower risk, with an HR of 0.73 compared to never users.

• Among those hospitalized with serious infections, the 30-day mortality rate per 1,000 person-years was 21.4 in the SLE cohort and 38.6 in the LN subcohort.

Citation: Feldman CH, Hiraki LT, Winkelmayer WC, et al. Serious infections among adult medicaid beneficiaries with systemic lupus erythematous and lupus nephritis. [Published online ahead of print May 25, 2015]. Arthritis Rheumatol. doi: 10.1002/art.39070.