Clinical characteristics and risk factors for Pneumocystis jirovecii pneumonia in patients with rheumatoid arthritis receiving adalimumab: a retrospective review and case–control study of 17 patients

Abstract

PCP may occur early in the course of adalimumab therapy in patients with RA. Careful monitoring, early diagnosis, and proper management are mandatory to secure a good prognosis for these patients.

Biological Therapy and Infection in Rheumatoid Arthritis Patients: Modern Aspects

“…При лечении ГИБП необходимо помнить о возможно-сти развития пневмоцистной Пн, которая по клиническим и рентгенологическим характеристикам может практиче-В соответствии с результатами одного из последних метаанализов риск развития серьезных коморбидных инфекций, рассчитанный с использованием статистической модели со случайным эффектом, у больных РА, получающих ГИБП, в 4,1 раза превосходит таковой при лечении БПВП ски не отличаться от «метотрексатного пневмонита» [64,65]. Госпитальная летальность от пневмоцистной Пн у больных РА составляет 30,8%.…”

Pneumocystis Jirovecii Pneumonia in Japanese Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor Inhibitors: A Pooled Analysis of 3 Agents

“…Notably, these incidence rates of PCP in Japan are higher than the corresponding figure (0.01%) reported from the United States. Therefore, we previously analyzed the clinical characteristics and risk factors for PCP in patients with RA in Japan treated with these 3 TNF inhibitors 7,8,9,10 . In most cases, PCP developed rapidly with respiratory failure, and P. jirovecii organisms could not be detected microscopically, requiring for diagnosis the PCR test for P. jirovecii DNA or the measurement of plasma or serum 1, 3-β-D-glucan levels.…”

“…Only some of the cases were in an immunocompromised state, showing a remarkable decrease in concentrations of serum immunoglobulins and the number of peripheral blood lymphocytes. Some of the risk factors for PCP were common to IFX and ETN, but others differed among the 3 TNF inhibitors 8,9,10 . It is possible that small sample size, patient background, the launch time of each drug, distinct mechanism of action among TNF inhibitors, or other unmeasured factors resulted in these differences in risk factors for PCP among the drugs.…”

“…We therefore merged and analyzed the data of our previous studies to identify risk factors for development of PCP common to these 3 TNF inhibitors. Details of the designs and the methods of our previous studies were published elsewhere 8,9,10 .…”

Pneumocystis Pneumonia in Inflammatory Bowel Disease: The Costs of Immunosuppression

“…Typically, the interval identified between the first infusion or dose and the start of infection is between 9 and 14 weeks [15,47]. Cases of PCP have also been reported in patients receiving adalimumab [3,50]. There are currently no published cases of PCP in association with certolizumab therapy.…”