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Master Thesis

Risque infectieux associé au traitement d'entretien de vascularite à anticorps anticytoplasme des polynucléaires neutrophiles : une étude rétrospective de 89 patients

Abstract : Introduction: Treatment of antineutrophil cytoplasmic antibody-associated vasculitis (AAV) with immunosuppressants has improved the prognosis of these patients but is responsible for potentially serious adverse events, including severe infections. These adverse events are responsible for significant mortality during the follow-up. Methods: We therefore decided to compare and analyze the infection rate and risk factors for infection between the 6th and 24th month after the cyclophosphamide induction therapy in patients with newly-diagnosed AAV at Caen University Hospital between January 2006 and December 2019. We compared the late severe infection-free survival (LSFI), defined by a Common Terminology Criteria for Adverse Events (CTCAE) ≥ 3, and the late infection-free survival of any severity (LIF) in patients receiving maintenance treatment with rituximab or azathioprine. We used Cox analysis to identify predictive factors of late infection. Results: In our cohort, there was no significant difference in LSFI survival during maintenance therapy between the rituximab group and the azathiorpine group (p=0.65). In contrast, LIF survival was lower in the rituximab group (p=0.03). Risk factors for severe infection regardless of maintenance therapy were diabetes, history of infection at induction, occurrence of severe infection within 6 months of induction, chronic urinary tract disease, chronic inflammatory disease, and active neoplasia. Conclusion: Rituximab treatment does not increase the risk of severe infection and the choice of preventive strategy should be individualized according to the different risk factors for late infections in these patients.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03332312
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Submitted on : Thursday, September 2, 2021 - 3:51:34 PM
Last modification on : Tuesday, October 19, 2021 - 11:34:51 PM
Long-term archiving on: : Friday, December 3, 2021 - 8:35:31 PM

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  • HAL Id : dumas-03332312, version 1

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Martin Gérard. Risque infectieux associé au traitement d'entretien de vascularite à anticorps anticytoplasme des polynucléaires neutrophiles : une étude rétrospective de 89 patients. Médecine humaine et pathologie. 2021. ⟨dumas-03332312⟩

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