Pneumocystis jirovecii pneumonia associated with etanercept treatment in patients with rheumatoid arthritis: a retrospective review of 15 cases and analysis of risk factors
详细信息 查看全文
- 作者：Michi Tanaka (1) (2)
Ryoko Sakai (1)
Ryuji Koike (1) (2) (3)
Yukiko Komano (2)
Toshihiro Nanki (1) (2)
Fumikazu Sakai (4)
Haruhito Sugiyama (5)
Hidekazu Matsushima (6)
Toshihisa Kojima (7)
Shuji Ohta (8)
Yoji Ishibe (9)
Takuya Sawabe (10)
Yasuhiro Ota (11)
Kazuhisa Ohishi (12)
Hajime Miyazato (13)
Yoshinori Nonomura (2)
Kazuyoshi Saito (14)
Yoshiya Tanaka (14)
Hayato Nagasawa (15)
Tsutomu Takeuchi (16)
Ayako Nakajima (17)
Hideo Ohtsubo (18)
Makoto Onishi (19)
Yoshinori Goto (20)
Hiroaki Dobashi (21)
Nobuyuki Miyasaka (2)
Masayoshi Harigai (1) (2) - 关键词：Pneumocystis jirovecii pneumonia ; Rheumatoid arthritis ; Etanercept ; Anti ; TNF therapy ; Opportunistic infection
- 刊名：Modern Rheumatology
- 出版年：2012
- 出版时间：November 2012
- 年：2012
- 卷：22
- 期：6
- 页码：849-858
- 参考文献：1. Feldmann M, Brennan FM, Maini RN. Role of cytokines in rheumatoid arthritis. Annu Rev Immunol. 1996;14:397-40. CrossRef
2. Maini R, St Clair EW, Breedveld F, Furst D, Kalden J, Weisman M, et al. Infliximab (chimeric anti-tumour necrosis factor alpha monoclonal antibody) versus placebo in rheumatoid arthritis patients receiving concomitant methotrexate: a randomised phase III trial. ATTRACT Study Group. Lancet. 1999;354(9194):1932-. CrossRef
3. Goekoop-Ruiterman YP, de Vries-Bouwstra JK, Allaart CF, van Zeben D, Kerstens PJ, Hazes JM, et al. Clinical and radiographic outcomes of four different treatment strategies in patients with early rheumatoid arthritis (the BeSt study): a randomized, controlled trial. Arthritis Rheum. 2005;52(11):3381-0. CrossRef
4. Smolen JS, Aletaha D, Koeller M, Weisman MH, Emery P. New therapies for treatment of rheumatoid arthritis. Lancet. 2007;370(9602):1861-4. CrossRef
5. Dixon WG, Symmons DP, Lunt M, Watson KD, Hyrich KL, Silman AJ. Serious infection following anti-tumor necrosis factor alpha therapy in patients with rheumatoid arthritis: lessons from interpreting data from observational studies. Arthritis Rheum. 2007;56(9):2896-04. CrossRef
6. Dixon WG, Watson K, Lunt M, Hyrich KL, Silman AJ, Symmons DP. Rates of serious infection, including site-specific and bacterial intracellular infection, in rheumatoid arthritis patients receiving anti-tumor necrosis factor therapy: results from the British Society for Rheumatology Biologics Register. Arthritis Rheum. 2006;54(8):2368-6. CrossRef
7. Komano Y, Tanaka M, Nanki T, Koike R, Sakai R, Kameda H, et al. Incidence and risk factors for serious infection in patients with rheumatoid arthritis treated with tumor necrosis factor inhibitors: a report from the Registry of Japanese Rheumatoid Arthritis Patients for Longterm Safety. J Rheumatol. 2011;38(7):1258-4. CrossRef
8. Bongartz T, Sutton AJ, Sweeting MJ, Buchan I, Matteson EL, Montori V. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serious infections and malignancies: systematic review and meta-analysis of rare harmful effects in randomized controlled trials. JAMA. 2006;295(19):2275-5. CrossRef
9. Koike T, Harigai M, Inokuma S, Inoue K, Ishiguro N, Ryu J, et al. Postmarketing surveillance of the safety and effectiveness of etanercept in Japan. J Rheumatol. 2009;36(5):898-06. CrossRef
10. Takeuchi T, Tatsuki Y, Nogami Y, Ishiguro N, Tanaka Y, Yamanaka H, et al. Postmarketing surveillance of the safety profile of infliximab in 5000 Japanese patients with rheumatoid arthritis. Ann Rheum Dis. 2008;67(2):189-4. CrossRef
11. Koike T, Harigai M, Ishiguro N, Inokuma S, Takei S, Takeuchi T, et al. Safety and effectiveness of adalimumab in Japanese rheumatoid arthritis patients: postmarketing surveillance report of the first 3,000 patients. Mod Rheumatol. 2011 (Epub ahead of print).
12. Furrer H, Egger M, Opravil M, Bernasconi E, Hirschel B, Battegay M, et al. Discontinuation of primary prophylaxis against / Pneumocystis carinii pneumonia in HIV-1-infected adults treated with combination antiretroviral therapy. Swiss HIV Cohort Study. N Engl J Med. 1999;340(17):1301-. CrossRef
13. Limper AH, Offord KP, Smith TF, Martin WJ 2nd. / Pneumocystis carinii pneumonia. Differences in lung parasite number and inflammation in patients with and without AIDS. Am Rev Respir Dis. 1989;140(5):1204-. CrossRef
14. Khanna D, McMahon M, Furst DE. Safety of tumour necrosis factor-alpha antagonists. Drug Saf. 2004;27(5):307-4. CrossRef
15. Takeuchi T, Kameda H. The Japanese experience with biologic therapies for rheumatoid arthritis. Nat Rev Rheumatol. 2010;6(11):644-2. CrossRef
16. Krajicek BJ, Thomas CF Jr, Limper AH. Pneumocystis pneumonia: current concepts in pathogenesis, diagnosis, and treatment. Clin Chest Med. 2009;30(2):265-8, vi.
17. Khot PD, Fredricks DN. PCR-based diagnosis of human fungal infections. Expert Rev Anti Infect Ther. 2009;7(10):1201-1. CrossRef
18. Marty FM, Koo S, Bryar J, Baden LR. (1?→?)Beta-d -glucan assay positivity in patients with / Pneumocystis ( / carinii) / jirovecii pneumonia. Ann Intern Med. 2007;147(1):70-.
19. Tasaka S, Hasegawa N, Kobayashi S, Yamada W, Nishimura T, Takeuchi T, et al. Serum indicators for the diagnosis of pneumocystis pneumonia. Chest. 2007;131(4):1173-0. CrossRef
20. Kameda H, Tokuda H, Sakai F, Johkoh T, Mori S, Yoshida Y, et al. Clinical and radiological features of acute-onset diffuse interstitial lung diseases in patients with rheumatoid arthritis receiving treatment with biological agents: importance of pneumocystis pneumonia in Japan revealed by a multicenter study. Intern Med. 2011;50(4):305-3. CrossRef
21. Tokuda H, Sakai F, Yamada H, Johkoh T, Imamura A, Dohi M, et al. Clinical and radiological features of Pneumocystis pneumonia in patients with rheumatoid arthritis, in comparison with methotrexate pneumonitis and Pneumocystis pneumonia in acquired immunodeficiency syndrome: a multicenter study. Intern Med. 2008;47(10):915-3. CrossRef
22. Komano Y, Harigai M, Koike R, Sugiyama H, Ogawa J, Saito K, et al. / Pneumocystis jirovecii pneumonia in patients with rheumatoid arthritis treated with infliximab: a retrospective review and case–control study of 21 patients. Arthritis Rheum. 2009;61(3):305-2. CrossRef
23. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31(3):315-4. CrossRef
24. Harigai M, Koike R, Miyasaka N. Pneumocystis pneumonia associated with infliximab in Japan. N Engl J Med. 2007;357(18):1874-. CrossRef
25. Nakajima H, Harigai M, Hara M, Hakoda M, Tokuda H, Sakai F, et al. KL-6 as a novel serum marker for interstitial pneumonia associated with collagen diseases. J Rheumatol. 2000;27(5):1164-0.
26. Nakamura H, Tateyama M, Tasato D, Haranaga S, Yara S, Higa F, et al. Clinical utility of serum beta-d -glucan and KL-6 levels in / Pneumocystis jirovecii pneumonia. Intern Med. 2009;48(4):195-02. CrossRef
27. Thomas CF Jr, Limper AH. Pneumocystis pneumonia. N Engl J Med. 2004;350(24):2487-8. CrossRef
28. Monnet X, Vidal-Petiot E, Osman D, Hamzaoui O, Durrbach A, Goujard C, et al. Critical care management and outcome of severe Pneumocystis pneumonia in patients with and without HIV infection. Crit Care. 2008;12(1):R28. CrossRef
29. Ewig S, Bauer T, Schneider C, Pickenhain A, Pizzulli L, Loos U, et al. Clinical characteristics and outcome of / Pneumocystis carinii pneumonia in HIV-infected and otherwise immunosuppressed patients. Eur Respir J. 1995;8(9):1548-3.
30. Thomas CF Jr, Limper AH. Pneumocystis pneumonia: clinical presentation and diagnosis in patients with and without acquired immune deficiency syndrome. Semin Respir Infect. 1998;13(4):289-5.
31. Sepkowitz KA. Opportunistic infections in patients with and patients without acquired immunodeficiency syndrome. Clin Infect Dis. 2002;34(8):1098-07. CrossRef
32. Iikuni N, Kitahama M, Ohta S, Okamoto H, Kamatani N, Nishinarita M. Evaluation of Pneumocystis pneumonia infection risk factors in patients with connective tissue disease. Mod Rheumatol. 2006;16(5):282-. CrossRef
33. Pareja JG, Garland R, Koziel H. Use of adjunctive corticosteroids in severe adult non-HIV / Pneumocystis carinii pneumonia. Chest. 1998;113(5):1215-4. CrossRef
34. Godeau B, Coutant-Perronne V, Le Thi Huong D, Guillevin L, Magadur G, De Bandt M, et al. / Pneumocystis carinii pneumonia in the course of connective tissue disease: report of 34 cases. J Rheumatol. 1994;21(2):246-1.
35. Delclaux C, Zahar JR, Amraoui G, Leleu G, Lebargy F, Brochard L, et al. Corticosteroids as adjunctive therapy for severe / Pneumocystis carinii pneumonia in non-human immunodeficiency virus-infected patients: retrospective study of 31 patients. Clin Infect Dis. 1999;29(3):670-. CrossRef
36. Ward MM, Donald F. / Pneumocystis carinii pneumonia in patients with connective tissue diseases: the role of hospital experience in diagnosis and mortality. Arthritis Rheum. 1999;42(4):780-. CrossRef
37. Greenberg JD, Reed G, Kremer JM, Tindall E, Kavanaugh A, Zheng C, et al. Association of methotrexate and tumour necrosis factor antagonists with risk of infectious outcomes including opportunistic infections in the CORRONA registry. Ann Rheum Dis. 2009;69(2):380-. CrossRef
38. Wolfe F, Caplan L, Michaud K. Treatment for rheumatoid arthritis and the risk of hospitalization for pneumonia: associations with prednisone, disease-modifying antirheumatic drugs, and anti-tumor necrosis factor therapy. Arthritis Rheum. 2006;54(2):628-4. CrossRef
39. Masur H, Kaplan JE, Holmes KK. Guidelines for preventing opportunistic infections among HIV-infected persons-002. Recommendations of the U.S. Public Health Service and the Infectious Diseases Society of America. Ann Intern Med. 2002;137(5 Pt 2):435-8.
40. Doran MF, Crowson CS, Pond GR, O’Fallon WM, Gabriel SE. Predictors of infection in rheumatoid arthritis. Arthritis Rheum. 2002;46(9):2294-00. CrossRef - 作者单位：Michi Tanaka (1) (2)
Ryoko Sakai (1)
Ryuji Koike (1) (2) (3)
Yukiko Komano (2)
Toshihiro Nanki (1) (2)
Fumikazu Sakai (4)
Haruhito Sugiyama (5)
Hidekazu Matsushima (6)
Toshihisa Kojima (7)
Shuji Ohta (8)
Yoji Ishibe (9)
Takuya Sawabe (10)
Yasuhiro Ota (11)
Kazuhisa Ohishi (12)
Hajime Miyazato (13)
Yoshinori Nonomura (2)
Kazuyoshi Saito (14)
Yoshiya Tanaka (14)
Hayato Nagasawa (15)
Tsutomu Takeuchi (16)
Ayako Nakajima (17)
Hideo Ohtsubo (18)
Makoto Onishi (19)
Yoshinori Goto (20)
Hiroaki Dobashi (21)
Nobuyuki Miyasaka (2)
Masayoshi Harigai (1) (2)
1. Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
2. Department of Medicine and Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
3. Clinical Research Center, Tokyo Medical and Dental University Hospital, Tokyo, Japan
4. Department of Diagnostic Radiology, International Medical Center, Saitama Medical University, Saitama, Japan
5. National Center for Global Health and Medicine, Tokyo, Japan
6. Saitama Red Cross Hospital, Saitama, Japan
7. Department of Orthopedic Surgery, Nagoya University School of Medicine, Nagoya, Japan
8. Hitachi Ltd., Taga General Hospital, Hitachi, Japan
9. Saijo Central Hospital, Saijo, Japan
10. Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima, Japan
11. Yasuhiro Clinic, Hamamatsu, Japan
12. Hamamatsu Medical Center, Hamamatsu, Japan
13. Shunan Memorial Hospital, Yamaguchi, Japan
14. The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
15. Department of Rheumatology and Clinical Immunology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
16. Division of Rheumatology, Department of Internal Medicine, Keio University, Tokyo, Japan
17. Institute of Rheumatology, Tokyo Women’s Medical University, Tokyo, Japan
18. Japanese Red Cross Society Kagoshima Hospital, Kagoshima, Japan
19. Center for Rheumatic Disease, Dohogo Spa Hospital, Matsuyama, Japan
20. Goto Medical Clinic, Hamamatsu, Japan
21. Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan - ISSN：1439-7609
文摘
Objectives The association of anti-tumor necrosis factor therapy with opportunistic infections in rheumatoid arthritis (RA) patients has been reported. The goal of this study was to clarify the clinical characteristics and the risk factors of RA patients who developed Pneumocystis jirovecii pneumonia (PCP) during etanercept therapy. Methods We conducted a multicenter, case–control study in which 15 RA patients who developed PCP were compared with 74 RA patients who did not develop PCP during etanercept therapy. Results PCP developed within 26?weeks following the first injection of etanercept in 86.7% of the patients. All PCP patients presented with a rapid and severe clinical course and the overall mortality was 6.7%. Independent risk factors were identified using multivariate analysis and included age ?5?years [hazard ratio (HR) 3.35, p?=?0.037], coexisting lung disease (HR 4.48, p?=?0.009), and concomitant methotrexate treatment (HR 4.68, p?=?0.005). In patients having a larger number of risk factors, the cumulative probability of developing PCP was significantly higher (p?<?0.001 for patients with two or more risk factors vs. those with no risk factor, and p?=?0.001 for patients with one risk factor vs. those with no risk factor). Conclusion Physicians must consider the possibility of PCP developing during etanercept therapy in RA patients, particularly if one or more risk factors are present.