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Opportunistic Infections in Rheumatic Diseases

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Fawziah Marra, Elaine Lo, Viktor Kalashnikov, Kathryn Richardson
BACKGROUND: Studies examining the risk of herpes zoster (HZ) associated with immunosuppressants, such as biologics, nonbiological disease-modifying antirheumatic drugs (nbDMARDs), or corticosteroids, have generated conflicting results. METHODS: We conducted a systematic literature search from January 1946 to February 2016. Search terms related to HZ, rheumatoid arthritis, psoriasis, psoriatic arthritis, systemic lupus erythematous, or inflammatory bowel disease, biologics, nbDMARDS, and corticosteroids were used...
October 2016: Open Forum Infectious Diseases
L H Calabrese, F Xie, H Yun, K Winthrop, J W Baddley, C Calabrese, J R Curtis
BACKGROUND: Herpes zoster (HZ) is an opportunistic infection caused by varicella zoster virus (VZV), and observed with increasing frequency in patients on immunosuppressive therapies. Prior literature has suggested that the risk of stroke may increase shortly after herpes zoster, but little is known about this association for patients with autoimmune (AI) diseases, who are at increased risk both for zoster and stroke. METHODS: Medicare data (2006-2013) was used to identify patients with autoimmune diseases...
September 2, 2016: Arthritis & Rheumatology
M I Domínguez-Mozo, E Toledano-Martínez, L Rodríguez-Rodríguez, M García-Montojo, R Alvarez-Lafuente, B Fernández-Gutiérrez
OBJECTIVES: To evaluate the presence of John Cunningham virus (JCV) DNA in patients with autoimmune rheumatic diseases (ARDs) treated with rituximab (RTX). METHOD: We assessed the JCV DNA levels in peripheral blood mononuclear cell (PBMC), serum, and urine samples by quantitative real-time polymerase chain reaction (qPCR) in a cohort of 42 ARD patients (20 of whom were being treated with RTX) and 42 healthy donors. Approximately 1 year later, we collected further samples from 32 of these 42 ARD patients, all of whom were being treated with RTX...
November 2016: Scandinavian Journal of Rheumatology
K L Winthrop, S A Novosad, J W Baddley, L Calabrese, T Chiller, P Polgreen, F Bartalesi, M Lipman, X Mariette, O Lortholary, M E Weinblatt, M Saag, J Smolen
No consensus has previously been formed regarding the types and presentations of infectious pathogens to be considered as 'opportunistic infections' (OIs) within the setting of biologic therapy. We systematically reviewed published literature reporting OIs in the setting of biologic therapy for inflammatory diseases. The review sought to describe the OI definitions used within these studies and the types of OIs reported. These findings informed a consensus committee (infectious diseases and rheumatology specialists) in deliberations regarding the development of a candidate list of infections that should be considered as OIs in the setting of biologic therapy...
December 2015: Annals of the Rheumatic Diseases
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