Abstract:
INTRODUCTION/OBJECTIVES:Pneumocystis jirovecii pneumonia (PJP) is a rare but potentially fatal opportunistic infection; however, consensus varies around which conditions or medications confer a level of risk sufficient to justify antibiotic prophylaxis for PJP. We used electronic health record (EHR) data to assess the current patterns of PJP prophylaxis, PJP outcomes, and prophylaxis-related adverse events among patients with rheumatic diseases who were receiving high-risk immunosuppressant drugs. METHODS:Data derive from the EHR of a large health system. We included new immunosuppressant users with diagnoses of vasculitis, myositis, or systemic lupus erythematosus. We calculated the proportion of patients who received PJP prophylaxis for each diagnosis and drug combination. We also calculated the number of PJP infections and the number of antibiotic adverse drug events (ADEs) per patient-year of exposure. RESULTS:We followed 316 patients for 23.2 + /- 14.2 months. Overall, 124 (39%) of patients received prophylactic antibiotics for PJP. At least 25% of patients with the highest risk conditions (e.g. vasculitis) or highest risk immunosuppressants (e.g. cyclophosphamide) did not receive PJP prophylaxis. We found no cases of PJP infection over 640 patient-years of follow up, including among those not receiving prophylaxis, and an overall incidence rate of ADEs of 2.2% per patient-year. CONCLUSIONS:PJP prophylaxis for patients with rheumatic conditions is inconsistent, with one quarter of patients who have high risk conditions or high risk immunosuppressants not receiving prophylaxis. However, given extremely low rates of PJP infection, but detectable ADEs to prophylactic antibiotics, our findings suggest that evidence to guide more personalized risk assessments are needed to inform PJP prophylaxis.
journal_name
Semin Arthritis Rheumjournal_title
Seminars in arthritis and rheumatismauthors
Schmajuk G,Jafri K,Evans M,Shiboski S,Gianfrancesco M,Izadi Z,Patterson SL,Aggarwal I,Sarkar U,Dudley RA,Yazdany Jdoi
10.1016/j.semarthrit.2018.10.018subject
Has Abstractpub_date
2019-06-01 00:00:00pages
1087-1092issue
6eissn
0049-0172issn
1532-866Xpii
S0049-0172(18)30263-4journal_volume
48pub_type
杂志文章abstract:BACKGROUND:The neurological and psychiatric manifestations of systemic lupus erythematosus (NPSLE) are a heterogeneous group of conditions with variable clinical presentation and significant morbidity and mortality. OBJECTIVES:Our aim was to comprehensively assess and present the evidence for treatments used in the ma...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2020.12.004
更新日期:2020-12-17 00:00:00
abstract::Our current hypothesis is that mechanical damage in the spine such as a disc prolapse can lead directly to pain. However, pain arising for this reason is usually of short duration. In many subjects, however, the mechanical problems lead to vascular damage and, in particular, venous obstruction and dilatation with endo...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/0049-0172(89)90020-6
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVES:To objectively measure physical activity levels in a cohort of juvenile dermatomyositis (JDM) patients; to compare physical capacity and health-related quality of life in JDM patients and their healthy controls (CTRL) matched by physical activity levels; and to associate physical activity variables with dise...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2016.03.010
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:To determine cross-sectionally the influence of risk factors on chronic pain following total joint replacement (TJR) of the knee (TKR) or the hip (THR). METHODS:Eight hundred sixty post-TKR and 928 post-THR patients were studied. Western Ontario and McMaster Osteoarthritis Index pain scores taken on average...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2011.07.002
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Behçet's syndrome (BS) is a well-recognized cause of Budd-Chiari syndrome (BCS); however, information about its clinical characteristics and outcome is limited. METHODS:We reviewed the records of about 9000 patients with BS registered at the multidisciplinary Behçet's syndrome outpatient clinic at Cerrahpas...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2014.10.014
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Comparison of naproxcinod (375 and 750 mg), placebo (up to 13 weeks), and naproxen 500 mg (all bid) for treatment of osteoarthritis (OA) signs and symptoms. METHODS:A 53-week, randomized, double-blind, parallel-group study. One thousand twenty patients with primary knee OA were randomized to naproxcinod 750 ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.semarthrit.2010.06.002
更新日期:2011-02-01 00:00:00
abstract::The early course of newly diagnosed RA among young adult patients (16-44 yr) is described from results of an ongoing study with a mean follow-up of 3.4 yr. Study diagnosis was based on the judgement of experienced rheumatologists, and data on several hundred variables were obtained on entry and annually for the purpos...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/0049-0172(76)90013-5
更新日期:1976-05-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence and characteristics of severe pyogenic, nonpyogenic, and opportunistic infections in polymyositis and dermatomyositis (PM/DM) patients and to evaluate the predictive values for infections on clinical presentation and biochemical findings of PM/DM to detect patients at risk for such i...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2010.08.003
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To analyze the clinical, microbiological, and radiologic features of patients without drug addiction suffering from spontaneous pyogenic vertebral osteomyelitis. METHODS:We collected all microbiologically proved cases of pyogenic vertebral osteomyelitis seen between January 1980 and December 1999 in a teachi...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1053/sarh.2002.29492
更新日期:2002-02-01 00:00:00
abstract::Current interpretation of nailfold capillaroscopy is largely based on qualitative and subjective parameters. These parameters make the accurate assessment of the extent of the nailfold microangiopathy difficult. The authors present a comprehensive method in which several quantitative or semiquantitative parameters are...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/0049-0172(90)90091-s
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVES:To determine the adequacy of calcium, folic acid, vitamin E, zinc, and selenium intake in patients with rheumatoid arthritis (RA). METHODS:We conducted an observational study on 48 patients (13 men, 35 women; mean age, 64.5 years) with RA attending a specialty clinic in New Zealand comparing their dietary i...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/s0049-0172(97)80018-2
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVES:To present the data supporting the possible relationship of ocular toxoplasmosis to antitumor necrosis factor-alpha (TNF-alpha) therapy in patients with rheumatoid arthritis (RA). METHODS:A Medline search was performed using the words "toxoplasmosis, anti-TNF-alpha antagonists, chorioretinitis." We report 2...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2006.08.004
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To review epidemiological studies dealing with the temporal and geographic variability in the occurrence of rheumatoid arthritis (RA) and clinical studies that address the variability of severity and manifestations among populations. METHODS:An extensive search of the literature, including a Medline search, ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(97)80012-1
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:To investigate the impact of indicators of unfavorable prognosis ("poor prognostic factors") on the achievement of low disease activity (LDA)/remission in patients with rheumatoid arthritis (RA). METHODS:Biologic DMARD-naïve patients with RA from three observational cohorts were examined. N = 713 patients st...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2018.09.003
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To review the clinical features, diagnosis, treatment, and outcome of interferon-induced Raynaud's phenomenon. METHODS:The medical literature was reviewed from 1967 to November 2001 with the assistance of a MEDLINE search using the key words: Raynaud, Interferon, ischemia, thrombosis and necrosis. A qualitat...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1053/sarh.2002.34606
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVES:The purpose of our study was to detect early clinical and laboratory signs that help to discriminate macrophage activation syndrome (MAS) from active systemic juvenile idiopathic arthritis (SJIA) without MAS. METHODS:Our retrospective study was based on reviewing the medical charts of the children admitted ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2014.09.004
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:To review published data on the perioperative management of antirheumatic treatment and perioperative outcome in patients with rheumatoid arthritis (RA). METHODS:The review is based on a MEDLINE (PubMed) search of the English-language literature from 1965 to 2005, using the index keywords "rheumatoid arthri...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2006.10.003
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:To conduct a systematic review of incidence and prevalence studies of rheumatoid arthritis (RA), based on the 1987 revised American College of Rheumatology (ACR) criteria, to compare their methodologies and summarize their results, and to investigate the possible geographic variations and changes over time i...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2006.08.006
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:To validate the ability of the American College of Rheumatology (ACR) clinical classification criteria and the ACR clinical plus radiographic classification criteria for osteoarthritis of the knee to predict articular cartilage damage. METHODS:Ninety subjects with knee osteoarthritis (OA) who were enrolled i...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.semarthrit.2005.06.002
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVES:To report 3 cases ANCA-associated vasculitis (AAV) that developed in patients suffering from systemic sclerosis (SSc) and to review previously reported cases. METHODS:We describe 3 patients diagnosed with SSc who developed severe AAV that presented as crescentic glomerulonephritis (GN) and/or alveolar hemor...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2010.11.001
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of colchicine in reducing the frequency of attacks in patients with PFAPA. STUDY DESIGN:We conducted a 6-month open label, randomized, controlled study among patients with PFAPA who attend the Pediatric Rheumatology Clinic at the Rambam Medical Center in Israel. A total of 18 patient...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2015.07.005
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the outpatient health service utilisation of young people (YP) with juvenile idiopathic arthritis (JIA) during transfer from paediatric to adult care in Germany. METHODS:Based on claims data of a large German statutory health fund (BARMER GEK) we conducted a cohort study of 2008-2014. Insured YP ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2017.05.003
更新日期:2017-10-01 00:00:00
abstract::Of 500 patients with systemic lupus erythematosus observed at our center, 150 fulfilled criteria for lupus nephritis. Of these 150 patients, 91% were female, and 67% were white. The mean age of onset was 26.2 years, and the mean follow-up duration was 11.7 years. Biopsies (n = 142) performed on 107 patients showed the...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/s0049-0172(95)80017-4
更新日期:1995-08-01 00:00:00
abstract::Gout, the most common inflammatory arthritis, is the result of hyperuricemia and inflammation induced by monosodium urate (MSU) crystal deposition. However, most people with hyperuricemia will never develop gout, implying a molecular-genetic contribution to the development of gout. Recent genomic studies reveal links ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2020.06.015
更新日期:2020-10-01 00:00:00
abstract::Macrophage activation syndrome (MAS) is a potentially life-threatening complication of systemic autoinflammatory/autoimmune diseases, generally systemic juvenile idiopathic arthritis and adult-onset Still's disease. It is characterized by an excessive proliferation of macrophages and T lymphocytes. Recent research rev...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2020.12.007
更新日期:2020-12-24 00:00:00
abstract:OBJECTIVE:Due to reduced physical activity, adults with arthritis experience significant disability and comorbidities including cardiovascular disease. This meta-analytic review integrates results from primary research studies testing interventions to increase physical activity in arthritis patients. METHODS:Extensive...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.semarthrit.2007.07.006
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:To identify if rheumatoid factor (RF) is predictor of response to rituximab (RTX), abatacept (ABT), and tocilizumab (TCZ) in rheumatoid arthritis (RA). METHODS:Systematic review and meta-analysis of clinical trials and observational studies based on a sensitive search. Meta-regression was used to explore cau...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.semarthrit.2012.11.007
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:This historical review summarizes the understanding of lupus erythematosus (LE) during the time of the career of William Osler and analyzes factors that may have retarded the clinical identification of this disease. METHODS:All of Osler's writings related to diseases that he defined as the "erythema group" w...
journal_title:Seminars in arthritis and rheumatism
pub_type: 传,历史文章,杂志文章
doi:10.1016/s0049-0172(97)80037-6
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:Therapeutic advances in ANCA-associated vasculitis (AAV) have improved patient survival, but mortality rates remain higher than the general population. Glucocorticoids contribute to AAV morbidity and mortality. We examined whether an 8-week glucocorticoid course in combination with rituximab (RTX) would induc...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2018.01.013
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:Amyloid deposition in multiple myeloma (MM) may lead to an arthropathy resembling rheumatoid arthritis (RA). Since a systematic description of its natural history is lacking, we have performed a systematic analysis of all published cases. METHODS:Literature review featuring backward and forward database sear...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2013.07.004
更新日期:2013-12-01 00:00:00