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Endocrine Abstracts (2019) 63 OC1.4 | DOI: 10.1530/endoabs.63.OC1.4

ECE2019 Oral Communications Calcium and Bone (5 abstracts)

Risk of sepsis, respiratory infections, and kidney or other genitourinary (GU) infections in patients with chronic hypoparathyroidism (HypoPT): a retrospective cohort study

Kristina Chen 1 , Gary Curhan 2 , Elvira Gosmanova 3 , Fan Mu 4 , Allison Briggs 4 , William Pajerowski 4 , Nicole Sherry 1 , Markus Ketteler 5 & Lars Rejnmark 6

1Shire Human Genetic Therapies, Inc., a member of the Takeda group of companies, Cambridge, MA, USA; 2Brigham and Women’s Hospital, Boston, MA, USA; 3Stratton VA Medical Center and Albany Medical College, Albany, NY, USA; 4Analysis Group Inc., Boston, MA, USA; 5Klinikum Coburg GmbH, Coburg, Germany; 6Aarhus University and Aarhus University Hospital, Aarhus, Denmark.

Background: Prior small studies have suggested increased risk of infections in patients with hypoparathyroidism (HypoPT). This study using a large managed care cohort evaluated whether chronic HypoPT is associated with increased risk of sepsis, respiratory infections, and kidney or other genitourinary (GU) infections.

Methods: A retrospective cohort study using a US commercial claims database (Q1 2007–Q2 2017) was conducted to examine the association between chronic HypoPT and the risk of each infection category (sepsis, respiratory, and kidney or other GU; all identified using diagnoses codes). The study cohort included chronic HypoPT patients (identified using diagnosis codes; excluding those receiving parathyroid hormone) and randomly selected non-HypoPT patients during 5 years of follow-up. For HypoPT patients, the first date of follow-up (i.e., index date) was the earliest HypoPT diagnosis date ≥6 months after the initial HypoPT diagnosis (to establish chronic HypoPT); for non-HypoPT patients, it was the date of a randomly selected medical claim. Patient characteristics at baseline (the 6 months prior to index date) and risk of each infection category were compared between cohorts. The risk of each infection category was assessed among patients free of the infection category during the baseline period using Kaplan-Meier analysis and Cox proportional hazards models adjusting for baseline demographic characteristics (age, sex, race, region, and index year).

Results: The study included 8097 chronic HypoPT patients and 40,485 non-HypoPT patients. At baseline, HypoPT patients were older than non-HypoPT patients (58.6 years vs. 47.3 years), a higher proportion were female (76.2% vs. 54.4%), and higher proportions had sepsis (1.4% vs. 0.8%), respiratory infections (20.6% vs. 16.6%), and kidney or other GU infections (10.8% vs. 5.9%) (all P<0.001). Kaplan-Meier analyses showed HypoPT patients had an increased risk of developing sepsis, respiratory infections, and kidney or other GU infections, as compared with non-HypoPT patients (all P<0.001). The adjusted hazard ratios (95% confidence intervals) associated with HypoPT versus non-HypoPT were 1.64 (1.42, 1.90) for sepsis, 1.20 (1.14, 1.25) for respiratory infections, and 1.41 (1.32, 1.50) for kidney or other GU infections (all P<0.001).

Conclusions: Chronic HypoPT was associated with increased risk of new occurrence of sepsis, respiratory infections, and kidney or other GU infections. Further research is warranted to understand the potential mechanisms for the relationship of chronic HypoPT and the observed risks of these infections.

Volume 63

21st European Congress of Endocrinology

Lyon, France
18 May 2019 - 21 May 2019

European Society of Endocrinology 

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