ArticleArthritis research & therapy2014
Prophylaxis for Pneumocystis pneumonia in patients with rheumatoid arthritis treated with biologics, based on risk factors found in a retrospective study.
Article in Arthritis research & therapy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Low-dose trimethoprim-sulfamethoxazole for prophylaxis ofFrontiers in pharmacology · 2025Pooled it
- Pooled it
- Trimethoprim-Sulfamethoxazole (Bactrim) Dose Optimization inInternational journal of environmental research and public health · 2022Pooled it
- Pooled it
- Low-Dose Glucocorticoids in Older Patients with Rheumatoid Arthritis: What Does the Evidence Say?Drugs & aging · 2024Review
- Opportunistic Infections, Mortality Risk, and Prevention Strategies in Patients With Vacuoles, E1 Enzyme, X-Linked, Autoinflammatory, Somatic (VEXAS) Syndrome.Open forum infectious diseases · 2024Article
- Targeted Therapy in Rheumatoid-Arthritis-Related Interstitial Lung Disease.Journal of clinical medicine · 2023Review
- Prognostic Factors Affecting Death in Patients with Rheumatoid Arthritis Complicated byInternational journal of molecular sciences · 2023Article
- Prophylaxis against pneumocystis pneumonia in rheumatoid arthritis patients treated with b/tsDMARDs: insights from 3787 cases in the FIRST registry.Rheumatology (Oxford, England) · 2022Article
- Estimation of treatment and prognostic factors of pneumocystis pneumonia in patients with connective tissue diseases.RMD open · 2021Article
- Risk for infections with glucocorticoids and DMARDs in patients with rheumatoid arthritis.RMD open · 2021Review
- Infectious Complications in Autoimmune Hemolytic Anemia.Journal of clinical medicine · 2021Review
- Practical approach to monitoring and prevention of infectious complications associated with systemic corticosteroids, antimetabolites, cyclosporine, and cyclophosphamide in nonmalignant hematologic diseases.Hematology. American Society of Hematology. Education Program · 2020Review
- Article
- Infection prevention in sarcoidosis: proposal for vaccination and prophylactic therapy.Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG · 2020Review
- An open-label, randomized controlled trial of sulfamethoxazole-trimethoprim forRheumatology advances in practice · 2020Article
- Prognostic factors of Pneumocystis pneumonia in patients with systemic autoimmune diseases.PloS one · 2019Observational
- Therapy and Management ofJournal of fungi (Basel, Switzerland) · 2018Review
- Risk factors for infectious complications of ANCA-associated vasculitis: a cohort study.BMC nephrology · 2018Article
- [Pneumocystis jirovecii pneumonia in patients with autoimmune diseases].Zeitschrift fur Rheumatologie · 2017Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPneumocystis pneumonia (PCP) is one of the most prevalent opportunistic infections in patients undergoing immunosuppressive therapy. In this article, we discuss risk factors for PCP development in patients with rheumatoid arthritis (RA) during the course of biologic therapy and describe a prophylactic treatment for PCP with trimethoprim/sulfamethoxazole (TMP/SMX). We also evaluate the effectiveness and safety of the treatment.
methodsWe retrospectively analyzed 702 RA patients who received biologic therapy and compared the characteristics of patients with vs. without PCP to identify the risk factors for PCP. Accordingly, we analyzed 214 patients who received the TMP/SMX biologic agents as prophylaxis against PCP at the start of treatment to evaluate their effectiveness and safety.
resultsWe identified the following as risk factors for PCP: age at least 65 years (hazard ratio (HR) = 4.37, 95% confidence interval (CI) = 1.04 to 18.2), coexisting pulmonary disease (HR = 8.13, 95% CI = 1.63 to 40.0), and use of glucocorticoids (HR = 11.4, 95% CI = 1.38 to 90.9). We employed a protocol whereby patients with two or three risk factors for PCP would receive prophylactic treatment. In the study with 214 patients, there were no cases of PCP, and the incidence of PCP was reduced to 0.00 per 100 person-years compared with that before the procedure (0.93 per 100 person-years). There were no severe adverse events induced by the TMP/SMX treatment.
conclusionsRA patients with two or three risk factors for PCP who are receiving biologic therapy can benefit from safe primary prophylaxis.
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