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Opportunistic Infections in Rheumatic Diseases

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5 papers 0 to 25 followers
Jun Won Park, Jeffrey R Curtis, Jinyoung Moon, Yeong Wook Song, Suhnggwon Kim, Eun Bong Lee
OBJECTIVES: To investigate the efficacy and safety of trimethoprim/sulfamethoxazole (TMP-SMX) as primary prophylaxis for pneumocystis pneumonia (PCP) in patients with rheumatic diseases receiving high-dose steroids. METHODS: The study included 1522 treatment episodes with prolonged (≥4 weeks) high-dose (≥30 mg/day prednisone) steroids in 1092 patients over a 12-year period. Of these, 262 treatment episodes involved TMP-SMX (prophylaxis group) while other episodes involved no prophylaxis (control group)...
May 2018: Annals of the Rheumatic Diseases
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
Leonard H Calabrese, Fenglong Xie, Huifeng Yun, Kevin L Winthrop, John W Baddley, Cassandra Calabrese, Jeffrey R Curtis
OBJECTIVE: Herpes zoster (HZ) is an opportunistic infection caused by varicella-zoster virus and observed with increasing frequency in patients receiving immunosuppressive therapies. The literature has suggested that the risk of stroke may increase shortly after HZ, but little is known about this association in patients with autoimmune diseases, who are at increased risk of both zoster and stroke. METHODS: Medicare data from January 1, 2006 through December 31, 2013 were used to identify patients with autoimmune diseases...
February 2017: 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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