Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients Receiving Rituximab

Curtis, Jeffrey R.; Jun, Kang Il; Kim, Tae Min; Heo, Dae Seog; Ha, Jong‐Won; Suh, Kyung‐Suk; Lee, Kwang‐Woong; Lee, Hajeong; Yang, Jaeseok; Kim, Min Jung; Choi, Yunhee; Lee, Eun Bong

doi:10.1016/j.chest.2021.11.007

Cited by 41 publications

(32 citation statements)

References 38 publications

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“…Moreover, Stegeman et al reported that TMP-SMX is associated with prolonged disease-free survival at the 2-year time point 39. Another recent retrospective study including 3524 patients in Korea also indicated TMP-SMX prophylaxis reduced the incidence of P. jirovecii infection in patients receiving RTX treatment 31. In our article, after adjustment for demographics, baseline features and therapy variables, TMP-SMX prophylaxis was found to be a protective factor of short-term survival.…”

Section: Discussionsupporting

confidence: 60%

“… 39 Another recent retrospective study including 3524 patients in Korea also indicated TMP-SMX prophylaxis reduced the incidence of P. jirovecii infection in patients receiving RTX treatment. 31 In our article, after adjustment for demographics, baseline features and therapy variables, TMP-SMX prophylaxis was found to be a protective factor of short-term survival. However, the long-term effect on survival, infection or relapse could not be examined by our existing data.…”

Section: Discussionmentioning

confidence: 57%

“…Gram-negative bacteria are the leading causative pathogens, and opportunistic infections are common in patients with AAV 18 20 25 29. Trimethoprim-sulfamethoxazole (TMP-SMX) was previously thought to protect patients with AAV from Pneumocystis jirovecii either with CYC or rituximab (RTX) treatment 15 30 31. TMP-SMX was recommended by EULAR32 and the British Society for Rheumatology (BSR) 33.…”

Section: Introductionmentioning

confidence: 99%

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Association between different infection profiles and one-year outcomes in ANCA-associated vasculitis: a retrospective study with monthly infection screening

Chen

Jiang

et al. 2022

RMD Open

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ObjectivesThis study aimed to explore clinical features of early infection in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and to identify the association between the infection profile of patients with AAV during the first 3 months and 1-year survival.MethodsA total of 415 newly diagnosed patients with AAV in the Department of Nephrology at Shanghai Ruijin Hospital from 2000 to 2018 were included. Four Cox regression models were used to analyse the association based on demographics, comorbidities, laboratory baseline index and therapy parameter. Infection screening was carried out monthly during the first 3 months after diagnosis.ResultsIn all, 377 episodes of infection were identified among 220 patients during the first 3 months. The overall survival after 1 year was 73.0%. Respiratory infection (210 episodes/164 persons) accounted for more than half of infections. Infection was independently associated with 1-year mortality (adjusted HR 2.32, 95% CI 1.27 to 4.23, p=0.006) after adjustment. Respiratory infection (adjusted HR 4.36, 95% CI 2.86 to 8.06, p<0.001), Gram-negative bacterial infection (adjusted HR 1.71, 95% CI 1.01 to 2.91, p=0.047) and fungal infection (adjusted HR 1.77, 95% CI 1.07 to 2.94, p=0.026) was identified as a risk factor for 1-year mortality. Trimethoprim-sulfamethoxazole (TMP-SMX) prophylaxis (adjusted HR 0.55, 95% CI 0.31 to 0.97, p=0.040) was protective for 1-year mortality.ConclusionsInfections, particularly respiratory infections, are a common and important class of complication in patients with AAV and are associated with early mortality. TMP-SMX prophylaxis might be necessary to improve short-term outcome. More consideration of infectious risk and regular infection screening should be given.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

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Association between different infection profiles and one-year outcomes in ANCA-associated vasculitis: a retrospective study with monthly infection screening

Chen

Jiang

et al. 2022

RMD Open

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“…Treatment with rituximab, a monoclonal antibody to CD20, has also been associated with PJP, likely due to the role of B cells in forming an immune response against P. jirovecii infection. A recent case–control study of 3524 patients receiving rituximab found the one‐year incidence of PJP following rituximab administration in the control group to be 4.11 per 100 person years, reduced to 1.47 with trimethoprim–sulfamethoxazole prophylaxis 3 …”

Section: Discussionmentioning

confidence: 99%

Hypercalcaemia in an immunocompromised patient: consider Pneumocystis jirovecii pneumonia

Bromley¹,

Phillips²,

Irish³

2022

Medical Journal of Australia

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“…Обзор литературы, включавший 18 случаев, выявил аналогичные результаты. В мае 2022 г. группа авторов под руководством J. W. Park [39] опубликовала результаты работы по выявлению ППн у пациентов, получающих РТМ. В ретроспективное исследование было включено 3524 пациента, из которых 559 страдали РЗ, остальные имели гематологическое заболевание или перенесли трансплантацию органов.…”

Section: терапия гибп как фактор риска ппнunclassified

Pneumocystis Pneumonia in Rheumatic Diseases: Prevention Issues

Гриднева

Белов

Аронова

2022

A&Ch

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The incidence of pneumocystis pneumonia (PCP) in patients with rheumatic diseases (RD) continues to increase. This is facilitated by the increasing use of genetically engineered biological agents in addition to the use of cytostatics and glucocorticoids. Mortality due to PCP among patients with RD is extremely high, so the issues of its prevention are relevant. European and American scientists focus on the frequency of detection of PCP and the determination of the proportionality of certain risk factors, while the recommendations for prevention are formulated cautiously. Asian medical communities are unanimous in their opinion about the need to prevent PCP, only the dosage of drugs and the duration of the course of treatment are discussed.

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Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients Receiving Rituximab

Cited by 41 publications

References 38 publications

Association between different infection profiles and one-year outcomes in ANCA-associated vasculitis: a retrospective study with monthly infection screening

Association between different infection profiles and one-year outcomes in ANCA-associated vasculitis: a retrospective study with monthly infection screening

Hypercalcaemia in an immunocompromised patient: consider Pneumocystis jirovecii pneumonia

Pneumocystis Pneumonia in Rheumatic Diseases: Prevention Issues

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