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Evaluation of the RABBIT Risk Score for serious infections
A Zink1, B Manger2, J Kaufmann3
1Programmbereich Epidemiologie, Deutsches Rheuma-Forschungszentrum Berlin, Ein Leibniz Institut, Berlin, Germany Klinik für Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Berlin, Germany.
The Rheumatoid Arthritis Observation of Biologic Therapy (RABBIT) Risk Score accurately predicts serious infections in rheumatoid arthritis (RA) patients. This validated tool aids clinicians in balancing treatment benefits and risks for better patient outcomes.
Area of Science:
- Rheumatology
- Infectious Disease Epidemiology
- Clinical Risk Stratification
Background:
- Rheumatoid arthritis (RA) patients face increased risk of serious infections, particularly with biologic therapies.
- Accurate risk assessment is crucial for optimizing treatment strategies and patient safety.
- The Rheumatoid Arthritis Observation of Biologic Therapy (RABBIT) Risk Score was previously developed to predict serious infections in RA.
Purpose of the Study:
- To validate the predictive accuracy of the established RABBIT Risk Score for serious infections.
- To assess the score's performance in an independent cohort of RA patients.
- To determine the score's reliability in identifying patients at varying infection risk levels.
Main Methods:
- Utilized data from RA patients enrolled in the German biologics register RABBIT after January 1, 2009.
- Calculated expected serious infection rates using the RABBIT Risk Score.
- Compared expected rates with observed serious infection rates in an independent evaluation cohort.
Main Results:
- Excellent agreement was observed between expected and actual serious infection rates across different treatment groups.
- For TNF inhibitor users, expected and observed rates were both 3.0 per 100 patient-years.
- For non-biological DMARD users, expected rates were 1.5/100 PY and observed rates were 1.8/100 PY.
- The score demonstrated high predictive power for both low and high-risk patient groups.
Conclusions:
- The RABBIT Risk Score is a dependable tool for assessing serious infection risk in individual RA patients.
- The score aids rheumatologists in making informed decisions by balancing treatment benefits and risks.
- It helps in avoiding high-risk treatment combinations, thereby improving clinical decision-making.
