Pneumococcal disease studies characteristics, pneumococcal disease incidence rates and incidence rate ratios
| Author, Year | Country | Study design | AIIRD, Controls, Sample size | Pneumococcal disease definition/ascertainment | IR AIIRD (100, 000 PY) | IR Controls (100, 000 PY) | IRR, 95% CI | LoE |
| Shea 201417 | USA | Retrospective cohort (three integrated healthcare claims repositories) | RA, SLE, Crohn’s disease, healthy controls (sample size NA) | Pneumonia and IPD/ICD-9 | 18–49 y – 13.0 50–64 y – 21.1 ≥65 y – 33.3 | 18–49 y – 1.8 50–64 y – 4.5 ≥65 y – 8.3 |
Pneumonia:
18 to 49 y –4.4 (3.8 to 5.2) 50 to 64 y –4.3 (3.8 to 4.7) ≥65 y – 4.0 (3.6 to 4.4) IPD: 18 to 49 y – 7.1 (4.9 to 10.1) 50 to 64 y – 4.7 (3.7 to 6) ≥65 y – 4 (3.0 to 5.3) | 2b |
| Wotton 201218 | UK | Retrospective cohort (English national linked Hospital Episode Statistics (1999–2008)) | RA 247 414 AS 20 569 SLE 20 005 Sjögren 12 002 SSc 9308 DM/PM 5223 PAN 1839 Immunocompetent controls (sample size of controls NA) | Pneumonia, IPD, pneumococcal meningitis/ICD-10 | NA | NA | RA 2.5 (2.4 to 2.5) AS 2.5 (2.3 to 2.8) SLE 5.0 (4.6 to 5.4) Sjögren 3.2 (2.9 to 3.5) SSc 4.2 (3.8 to 4.7) DM/PM 3.9 (3.4 to 4.5) PAN 5.0 (4.0 to 6.0) | 4 |
| Luijten 201420 | Nether-lands | Retrospective cohort | 260 SLE | Pneumonia leading to hospitalisation/ medical records+positive cx for S. pneumoniae | 201 | NA | NA | 2b |
| Schurder 201821 | France | Retrospective cohort | 190 SLE | Pneumonia leading to hospitalisation: positive cx for S. pneumoniae or pneumococcal Ag in urine | 236 | NA | NA | 2b |
| Shigayeva 201619 | Canada | Population-based surveillance for IPD | 20 427 AIIRD (SLE, SSc, Sjögren, PM/DM); 3 973 048 controls | IPD/Clinical diagnosis and positive cx for S. pneumoniae | 20 | 4.8 | NA | 2b |
| Bachkhaus 201623 | Sweden | Retrospective cohort | 8500 RA, 830 SLE; controls (sample size NA) | IPD/Clinical diagnosis and positive cx for S. pneumoniae | RA – 72 SLE – 213 | NA | RA 4.9 (3.9 to 6.1) SLE 14.2 (9.6 to 21.3) | 2b |
| Weycker 201622 | USA | Retrospective cohort USA (healthcare database claims repositories) | RA, SLE (sample size NA) | IPD/Inpatients – ICD-9; outpatients – ICD-9 +HCPCS/NDC codes for antibiotic therapy | 18–64 y – 17.8 ≥65 y – 33.3 | 18–64 y – 2.7 ≥65 y – 8.3 | 18 to 64 y – 6.6 (5.4 to 8.0) ≥65 y – 4 (4.0 to 5.3) | 2b |
Ag, antigen; AIIRD, autoimmune inflammatory rheumatic disease(s); AS, ankylosing spondylitis; cx, culture; DM, dermatomyositis; GCA, giant cell arteritis; HCPCS/NDC, Healthcare Common Procedure Coding System/National Drug Codes; IR, incidence ratio; IRR, incidence rate ratio; LoE, level of evidence; NA, non-available/non-applicable; PAN, polyarteritis nodosa; PM, polymyositis; PsA, psoriatic arthritis; PY, patient years; RA, rheumatoid arthritis; SLE, systemic lupus erythematosus; SSc, systemic sclerosis; y, years.