Evidence map›Paper›PMID 40797037›Full record

ArticleClinical rheumatology2025

Risk factors of cytomegalovirus reactivation in patients with rheumatic musculoskeletal diseases undergoing remission induction therapy with high-dose glucocorticoids; a prospective short-term cohort study.

Yuichiro Ota, Masaru Takeshita, Yasushi Kondo, Shuntaro Saito, Jun Kikuchi, Hironari Hanaoka, Tsutomu Takeuchi, Yuko Kaneko

Abstract read
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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yuichiro OtaDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Masaru TakeshitaDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Yasushi KondoDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Shuntaro SaitoDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Jun KikuchiDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Hironari HanaokaDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Tsutomu TakeuchiDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
Yuko KanekoDivision of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan. ykaneko.z6@keio.jp.ORCID http://orcid.org/0000-0003-2646-5765

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo elucidate the risk factors of cytomegalovirus (CMV) infection and the involvement of immunity status in CMV infection in patients with rheumatic musculoskeletal disease during remission induction therapy.

methodsPatients with rheumatic musculoskeletal disease who underwent induction therapy with high-dose glucocorticoids were consecutively enrolled. All patients were screened for CMV-IgG at baseline and monitored weekly for CMV pp65 antigen in polymorphonuclear leukocytes from peripheral blood until discharge. The titres of antibodies against individual viral antigens were examined using cell-based flow cytometry.

resultsA total of 157 patients (136 CMV-IgG-positive and 21 CMV-IgG-negative) were enrolled. CMV infection occurred in 52 (33.1%) patients, all of whom were CMV-IgG-positive (38.2% of CMV-IgG-positive patients). Multivariable analysis revealed that the initial prednisolone dose > 0.91 mg/kg/day (odds ratio [OR] 4.5, P < 0.01), intravenous cyclophosphamide (OR 3.3, P < 0.01), diabetes mellitus (OR 4.8, P = 0.01), and a history of malignancy (OR 2.6, P = 0.04) were independent relevant risk factors for CMV infection. While the titres of CMV-IgG and antibodies to individual CMV antigens were not significant for CMV infection, lymphocyte counts were significantly decreased from baseline to CMV infection (985/µL vs 622/µL, P = 0.03) in the CMV infection group treated with anti-CMV agents.

conclusionsThe risk factors for CMV infection short-term after the initiation of induction therapy in patients with rheumatic musculoskeletal diseases were treatment regimens and comorbidities. Decreased lymphocyte counts were more relevant than humoral immunity for CMV infection and the necessity of anti-CMV agents. Key Points • CMV infection during remission induction therapy was caused by reactivation of latent infection. • The risk factors for short-term CMV infection include treatment regimen and comorbidities. • Decreased lymphocyte counts is more relevant than humoral immunity in CMV infection and the necessity of anti-CMV agents.

Indexed as

CytomegalovirusCytomegalovirus InfectionsGlucocorticoidsMusculoskeletal DiseasesRheumatic DiseasesVirus ActivationAdultAgedAntibodies, ViralFemaleHumansImmunoglobulin GMaleMiddle AgedPrednisoloneProspective StudiesAntibodies, ViralGlucocorticoidsImmunoglobulin GPrednisoloneAutoimmune diseasesCytomegalovirusRemission induction

Identifiers

PMID40797037

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.