Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients with Connective Tissue Diseases

Vananuvat, Passawee; Suwannalai, Parawee; Sungkanuparph, Somnuek; Limsuwan, Ticha; Ngamjanyaporn, Pintip; Janwityanujit, Suchela

doi:10.1016/j.semarthrit.2011.05.004

Cited by 76 publications

(40 citation statements)

References 26 publications

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“…To limit toxicity, target 12-hour tacrolimus trough levels were 5–8 ng/mL, which is lower than that used in most post-transplant patients (31). Prophylaxis for pneumocystis jiroveci pneumonia was prescribed, usually with sulfamethoxazole/trimethoprim, which has been demonstrated to be safe and effective against this pathogen (32). …”

Section: Methodsmentioning

confidence: 99%

Benefit of adjunctive tacrolimus in connective tissue disease-interstitial lung disease

Witt

Demchuk

Curran

et al. 2016

Pulmonary Pharmacology & Therapeutics

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We evaluated the safety and effectiveness of adjunctive tacrolimus therapy with conventional immunosuppression in patients with severe connective tissue disease-related interstitial lung disease (CTD-ILD). We included patients from our interstitial lung disease (ILD) registry with CTD-ILD, in whom tacrolimus was added to corticosteroids and an additional immunosuppressive agent. Demographic data, clinical features, lung function, radiographic images, and pathologic findings were reviewed. Effectiveness was assessed by comparing pulmonary function tests (PFTs) closest to tacrolimus initiation to PFTs approximately 6–12 months later. Corticosteroid dose at these time points was also evaluated. We report adverse events attributed to tacrolimus. Seventeen patients with CTD-ILD were included in adverse event analysis; twelve were included in efficacy analysis. Length of tacrolimus therapy ranged from 6 to 110 months (mean 38.8 months ± 31.4). The mean improvement in percent predicted total lung capacity was 7.5% ± 11.7 (p=0.02). Forced vital capacity mean improvement was 7.4% ± 12.5 (p=0.06). The average decrease in corticosteroid dose at follow-up was 20.3mg ± 25.2 (p=0.02) with complete discontinuation in six patients. No patients experienced a life-threatening adverse event attributed to tacrolimus. Tacrolimus can be effective and is well tolerated as an adjunctive therapy and allows tapering of corticosteroids.

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Section: Methodsmentioning

confidence: 99%

Benefit of adjunctive tacrolimus in connective tissue disease-interstitial lung disease

Witt

Demchuk

Curran

et al. 2016

Pulmonary Pharmacology & Therapeutics

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“…Среди пациентов с систем-ными РЗ рандомизированные контролируемые исследо-вания по профилактике ППн не проводили. В ретроспек-тивной работе P. Vanonuvat и соавт., включавшей 132 больных с воспалительными РЗ (СКВ, ДМ, болезнь Бехчета, васкулит), назначение профилактики ко-тримо ксазолом привело к снижению абсолютного риска развития ППн на 7,3% [31]. Подобное снижение риска наблюдали и в других ретроспективных исследованиях [15,19].…”

Section: препараты для профилактики ппнunclassified

“…НР включали тошноту, диарею, реакции гиперчув-ствительности (сыпь, лихорадка), повышение уровней кре-атинина и трансаминаз, лейкопению, редко -такие тяже-лые иммуноопосредованные реакции, как синдром Стивенса -Джонсона и асептический менингит. Среди больных с системными РЗ частота НР при профилактиче-ском применении ко-тримоксазола составляла 8,5-20% [31,32]. Абсолютное большинство НР у этих пациентов претерпевало полное обратное развитие после отмены препарата.…”

Section: препараты для профилактики ппнunclassified

Pneumocystic Pneumonia in Rheumatic Diseases: Current Issues in Prophylaxis

Белов¹,

Тарасова²,

Буханова³

2017

Med. sov.

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“…In contrast, there are no published guidelines for PCP prophylaxis among patients with rheumatologic diseases receiving immunosuppressive drugs. Chemoprophylaxis has been recommended in patients with rheumatologic diseases such as Systemic lupus erythematosus, Dermatomyositis/ Polymyositis and Wegener's granulomatosis who are treated with significant doses of glucocorticoids (≥20 mg of prednisone daily for one month or longer) in combination with a second immunosuppressive drug, particularly a cytotoxic agent due to a high incidence of PCP (33)(34)(35). TMP-SMX is the first choice prophylaxis for non-HIV PCP as well as HIV PCP, and is the only agent demonstrated to be more effective than placebo in prospective randomized trials (grade A recommendation) (36,37).…”

Section: Prophylaxismentioning

confidence: 99%