Infection Rate among SLE Patients who Received Intravenous Cyclophosphamide in Chonburi Hospital
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Abstract
BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. In severe cases, treatment with immunosuppressive agents, such as Intravenous Cyclophosphamide (IVCY), is required, which may increase the risk of serious infections.
OBJECTIVE: To determine the incidence rate and associated factors of severe infection in SLE patients receiving Intravenous Cyclophosphamide (IVCY).
METHODS: This study was a retrospective cohort study of SLE patients who received IVCY between January 2015 and July 2023. Data were collected from medical records, including clinical characteristics, dosing regimens, and infection outcomes. Descriptive statistics and Cox proportional hazards regression were used to analyze factors associated with severe infections.
RESULTS: Among the 141 patients (mean age 29.9 years, 92.2% female), the rate of severe infection was 15.5 per 100 person-years, with a proportion of 25.5% and a mortality rate of 11.4%. Independent risk factors for severe infections included reduced renal function (eGFR <60 ml/min/1.73m2 (HR 4.07, p<0.01) and concomitant administration of Pulse Methylprednisolone (HR 2.68, p<0.01).
CONCLUSIONS: SLE patients receiving Intravenous cyclophosphamide are at increased risk of severe infection, particularly those with impaired renal function or those receiving Pulse Methylprednisolone. Risk stratification and appropriate preventive strategies may help reduce infectious complications in this population.
Thaiclinicaltrials.org number, TCTR20250428002
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