Background
Methods
Ethical statements
Study design and data source
Definitions of NTM infection
Study samples
Incident SS patients identified from whole Taiwanese population
Matched non-SS individuals selected from representative one million populations
Potential confounders
Statistical analysis
Results
Characteristics of the study population
Non- SS | SS | ||
---|---|---|---|
(n = 98,310) | (n = 6554) |
P-value | |
Age, years (mean ± SD) | 54 ± 14 | 54 ± 14 | 1 |
< 50 years | 34,140 (34.7) | 2276 (34.7) | |
≥ 50 years | 64,170 (65.3) | 4278 (65.3) | |
Gender | 1 | ||
Female | 86,760 (88.3) | 5784 (88.3) | |
Male | 11,550 (11.8) | 770 (11.8) | |
CCI (mean ± SD) | 0.4 ± 1.0 | 0.5 ± 0.9 | <0.001 |
CCI group | |||
0 | 76,836 (78.2) | 4541 (69.3) | |
≥ 1 | 21,474 (21.8) | 2013 (30.7) | |
Medications during all follow-up period | |||
Immunosuppressants | 837(0.9) | 1349(20.6) | <0.001 |
Methotrexate | 391(0.4) | 563(8.6) | <0.001 |
Azathioprine | 84(0.1) | 819(12.5) | <0.001 |
Cyclophosphamide | 425(0.4) | 208(3.2) | <0.001 |
Steroid | 38,348(39.0) | 4559(69.6) | <0.001 |
Medications during the first year | |||
Immunosuppressants | 413 (0.4) | 955 (14.6) | <0.001 |
Methotrexate | 214 (0.2) | 360 (5.5) | <0.001 |
Azathioprine | 41 (0.0) | 572 (8.7) | <0.001 |
Cyclophosphamide | 178 (0.2) | 150 (2.3) | <0.001 |
Steroid | 19,828 (20.2) | 3588 (54.8) | <0.001 |
Comparison of the incidence of NTM infection among SS patients with that among non-SS individuals
Variable | Total | Event (%) | Total person-years | Incidence Rate (/105 years) | IRR (95%CI) |
---|---|---|---|---|---|
The entire period | |||||
Non- SS | 98,310 | 9 (0.01) | 312,435 | 3 | 1 |
SS | 6554 | 4 (0.06) | 18,365 | 22 | 7.56 (2.33–24.55) |
SS treated without immunosuppressants | 5205 | 1 (0.02) | 14,196 | 7 | 2.45 (0.31–19.30) |
SS treated with immunosuppressants | 1349 | 3 (0.22) | 4169 | 72 | 24.98 (6.76–92.27) |
Total | 104,864 | 13 (0.01) | 330,800 | 4 | |
1st year | |||||
Non- SS | 98,310 | 3 (0.00) | 95,803 | 3 | 1 |
SS | 6554 | 3 (0.05) | 5970 | 50 | 16.05 (3.24–79.51) |
SS treated without immunosuppressants | 5599 | 1 (0.02) | 5089 | 20 | 6.27 (0.65–60.33) |
SS treated with immunosuppressants | 955 | 2 (0.21) | 881 | 227 | 72.51 (12.12–433.98) |
Total | 104,864 | 6 (0.01) | 101,773 | 6 |
Comparison of the incidence of NTM infection among SS patients with that among non-SS individuals during the first year of follow-up
Risk of NTM infection in patients with SS and in subgroups based on age, gender, and comorbidities
Univariate analysis | Model A | Model B | ||||
---|---|---|---|---|---|---|
HR | (95%CI) | HR | (95%CI) | HR | (95%CI) | |
Group | ||||||
Non- SS | Reference | Reference | Reference | Reference | Reference | Reference |
SS | 7.66 | (2.36–24.94) | 3.17 | (0.70–14.24) | ||
SS treated without immunosuppressants | 2.47 | (0.31–19.53) | 1.95 | (0.24–15.68) | ||
SS treated with immunosuppressants | 25.45 | (6.88–94.05) | 17.77 | (4.53–69.61) | ||
Age | ||||||
< 50 years | Reference | Reference | Reference | Reference | Reference | Reference |
≥ 50 years | 1.82 | (0.50–6.60) | 1.63 | (0.43–6.19) | 1.64 | (0.43–6.24) |
Gender | ||||||
Female | Reference | Reference | Reference | Reference | Reference | Reference |
Male | 3.50 | (1.08–11.36) | 3.34 | (1.02–10.96) | 3.27 | (0.99–10.74) |
CCI group | ||||||
0 | Reference | Reference | Reference | Reference | Reference | Reference |
≥ 1 | 1.55 | (0.48–5.04) | 0.97 | (0.29–3.30) | 1.00 | (0.30–3.41) |
Medications | ||||||
Immunosuppressants | 13.74 | (3.78–49.94) | 4.89 | (0.94–25.33) | ||
Methotrexate | 18.74 | (4.15–84.56) | ||||
Azathioprin | 21.26 | (4.71–95.91) | ||||
Cyclophosphamide | 27.86 | (6.18–125.70) | ||||
Steroid | 3.94 | (1.08–14.37) | 2.65 | (0.68–10.26) | 2.72 | (0.70–10.55) |
Univariate analysis | Model A | Model B | ||||
---|---|---|---|---|---|---|
HR | (95%CI) | HR | (95%CI) | HR | (95%CI) | |
Group | ||||||
Non- SS | Reference | Reference | Reference | Reference | Reference | Reference |
SS | 16.06 | (3.24–79.60) | 5.22 | (0.71–38.64) | ||
SS treated without immunosuppressants | 6.28 | (0.65–60.42) | 4.04 | (0.39–41.85) | ||
SS treated with immunosuppressants | 72.39 | (12.09–433.31) | 33.33 | (4.37–254.23) | ||
Age | ||||||
< 50 years | Reference | Reference | Reference | Reference | Reference | Reference |
≥ 50 years | 2.66 | (0.31–22.76) | 1.60 | (0.17–15.09) | 1.61 | (0.17–15.25) |
Gender | ||||||
Female | Reference | Reference | Reference | Reference | Reference | Reference |
Male | 3.81 | (0.70–20.79) | 2.92 | (0.53–16.19) | 2.85 | (0.51–15.80) |
CCI group | ||||||
0 | Reference | Reference | Reference | Reference | Reference | Reference |
≥ 1 | 6.89 | (1.26–37.61) | 4.05 | (0.67–24.28) | 4.16 | (0.69–24.98) |
Medications | ||||||
Immunosuppressants | 39.16 | (7.17–213.81) | 6.21 | (0.75–51.40) | ||
Steroid | 6.94 | (1.27–37.90) | 2.55 | (0.37–17.46) | 2.65 | (0.38–18.24) |