LAUSR

OBJECTIVE We compared the incidences of four opportunistic infections (OI) in patients with rheumatoid arthritis (RA) treated with molecular-targeted drugs from big claims data. MATERIALS AND METHODS We identified 205 906 patients with RA who were prescribed molecular-targeted drugs 2010-2017 from the National Database of Japan, and calculated the incidence of four OIs (Pneumocystis pneumonia [PCP], tuberculosis [TB], nontuberculous mycobacterial infection [NTM], and herpes zoster [HZ]). RESULTS The total number of PCP, TB, NTM, and HZ patients with biological disease-modifying antirheumatic drugs (bDMARDs) or tofacitinib treatment history in RA were 765, 1158, 834, and 18 336, respectively. The incidence rates (IRs) of each OI for all bDMARDs were 0.14, 0.14, 0.09, and 2.40 per 100 person-years, respectively; while for tofacitinib they were 0.22, 0.22, 0.07, and 7.00 per 100 person-years. No big difference was observed among bDMARDs. All OIs showed higher incidence in those older than 65 years; but PCP, NTM and HZ showed no difference between those 65-74 years old and those over 75 years old. The median of occurrence was the third, seventh, ninth, and thirteenth month after treatment, respectively. CONCLUSION We counted real IRs of OIs for the whole nation from big claims data.