Pieringer H, et al. - This article was written with the objective to research whether rheumatoid arthritis (RA) patients admitted to an intensive care unit (ICU) because of infection have higher Rheumatoid Arthritis Observation of Biologic Therapy (RABBIT) risk scores compared to control RA patients. It was concluded that the utilization of tDMARDs was related to lower odds of ICU admission. They also mentioned that the bDMARDs were not related to ICU admission in an adjusted analysis. For ICU admission, COPD, CKD, and age were strong risk factors.

• From January 2002 to December 2013, total 74 RA patients (32.4% male) admitted to an ICU because of infection.
• In this cross-sectional study, 74 frequency-matched control RA patients (16.2% male) were incorporated.
• There was strong proof for a higher RABBIT risk score in ICU patients (median 2.0; IQR 1.3-3.2) as compared to controls (1.3; IQR 0.8-2.0; p < 0.0001).
• Traditional disease-modifying anti-rheumatic drugs (DMARDs) (82.4 vs 64.9%; p = 0.015) and biological DMARDs (28.4 vs 14.9%; p = 0.012) were more frequently given to RA patients without ICU admission.
• Glucocorticoid users were more frequently found in the ICU group (51.4 vs 31.1%; p = 0.012).
• In a multivariable analysis tDMARD use was related to lower (OR 0.38; 95% CI 0.15-0.93; p = 0.034) and glucocorticoid use with borderline higher odds of ICU admission (OR 2.05; 95% CI 0.92–4.58; p = 0.078).
• Chronic obstructive pulmonary disease (OR 2.89; 95% CI 1.10-7.54; p = 0.03), chronic kidney disease (OR 16.08; 95% CI 2.00-129.48; p = 0.009), and age category (OR 2.67; 95% CI 1.46-4.87; p = 0.001) were strongly associated with ICU admission.
• There was a strong trend towards higher odds of ICU admission with increasing RABBIT risk score.