Risk factors for severe infections in secondary immunodeficiency: a retrospective US administrative claims study in patients with hematological malignancies

Abstract

Real-world data are lacking to identify patients with secondary immunodeficiency (SID) who may benefit most from anti-infective interventions. This retrospective analysis used the IQVIA PharMetrics® Plus database to assess baseline characteristics associated with risk of severe infections post-SID diagnosis in patients with hematological malignancies. In 4066 patients included, the mean number of any and severe infections per patient in the one-year pre-SID diagnosis period was 9.5 and 0.7, respectively. Post-SID diagnosis, the mean annualized number of any and severe infections was 19.1 and 1.5, respectively. Receiver operating characteristic curve analysis identified a threshold (cutoff) of three bacterial infections at baseline as optimally predictive of severe infections post-SID diagnosis. Multivariate analysis indicated that hospitalizations, infections (≥3), or antibiotic use pre-SID diagnosis were predictive of severe infections post-SID diagnosis. Evaluation of these risk factors could inform clinical decisions regarding which patients may benefit from prophylactic anti-infective treatment, including immunoglobulin replacement if warranted.

Keywords:

• Secondary infections
• secondary immunodeficiency
• infection risk factors
• hypogammaglobulinemia
• hematological malignancies

Acknowledgements

Editorial assistance was provided by Meridian HealthComms, funded by CSL Behring.

Disclosure statement

This study was funded by CSL Behring. RM and GE are employees and shareholders of CSL Behring. VD is an employee of IQVIA which received funding from CSL Behring for this study. BDS received fees from CSL Behring for advisory board activity and travel support. SJ has been a speaker and involved in advisory boards, conferences, clinical trials, DSMB or projects with CSL Behring, Shire, Takeda, Thermofisher, Swedish Orphan Biovitrum, Biotest, Binding Site, BPL, Octapharma, Sanofi, LFB, Pharming, Biocryst, Zarodex, Weatherden and UCB Pharma. MD has received consulting fees from IQVIA. DCV has received salary support (clinician-scientist, Junior 2) from Fonds de la recherche en santé du Québec and travel fees from CSL Behring and has been involved in clinical studies with Cidara Therapeutics and Janssen Pharmaceuticals; DCV has been a speaker and/or involved in advisory boards with CSL Behring, Merck Canada, Novartis Canada, Shire/Takeda, and UCB Pharma.

Data availability statement

The data that support the findings of this study are available from the corresponding author, SJ, upon reasonable request.

Additional information

Funding

This study was funded by CSL Behring.