Clinical characteristics and risk factors for Pneumocystis jirovecii pneumonia in patients with rheumatoid arthritis receiving adalimumab: a retrospective review and caseontrol study of 17 patients
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- 作者：Kaori Watanabe (1) (2)
Ryoko Sakai (1) (2)
Ryuji Koike (1) (2) (3)
Fumikazu Sakai (4)
Haruhito Sugiyama (5)
Michi Tanaka (1) (2)
Yukiko Komano (2)
Yuji Akiyama (6)
Toshihide Mimura (6)
Motohide Kaneko (7)
Hitoshi Tokuda (8)
Takenobu Iso (9)
Mitsuru Motegi (10)
Kei Ikeda (11)
Hiroshi Nakajima (11)
Hirofumi Taki (12)
Tetsuo Kubota (13)
Hirotaka Kodama (14)
Shoji Sugii (15)
Takashi Kuroiwa (16)
Yasushi Nawata (17)
Kazuko Shiozawa (18)
Atsushi Ogata (19)
Shigemasa Sawada (20)
Yoshihiro Matsukawa (21)
Takahiro Okazaki (22)
Masaya Mukai (23)
Mitsuhiro Iwahashi (24)
Kazuyoshi Saito (25)
Yoshiya Tanaka (25)
Toshihiro Nanki (1) (2)
Nobuyuki Miyasaka (2) (26)
Masayoshi Harigai (1) (2) - 关键词：Adalimumab ; Pneumocystis jirovecii pneumonia ; Rheumatoid arthritis ; TNF antagonist
- 刊名：Modern Rheumatology
- 出版年：2013
- 出版时间：November 2013
- 年：2013
- 卷：23
- 期：6
- 页码：1085-1093
- 全文大小：
- 作者单位：Kaori Watanabe (1) (2)
Ryoko Sakai (1) (2)
Ryuji Koike (1) (2) (3)
Fumikazu Sakai (4)
Haruhito Sugiyama (5)
Michi Tanaka (1) (2)
Yukiko Komano (2)
Yuji Akiyama (6)
Toshihide Mimura (6)
Motohide Kaneko (7)
Hitoshi Tokuda (8)
Takenobu Iso (9)
Mitsuru Motegi (10)
Kei Ikeda (11)
Hiroshi Nakajima (11)
Hirofumi Taki (12)
Tetsuo Kubota (13)
Hirotaka Kodama (14)
Shoji Sugii (15)
Takashi Kuroiwa (16)
Yasushi Nawata (17)
Kazuko Shiozawa (18)
Atsushi Ogata (19)
Shigemasa Sawada (20)
Yoshihiro Matsukawa (21)
Takahiro Okazaki (22)
Masaya Mukai (23)
Mitsuhiro Iwahashi (24)
Kazuyoshi Saito (25)
Yoshiya Tanaka (25)
Toshihiro Nanki (1) (2)
Nobuyuki Miyasaka (2) (26)
Masayoshi Harigai (1) (2)
1. Department of Pharmacovigilance, Graduate School of Medical and Dental Sciences, Tokyo Medical 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 Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
3. Clinical Research Center, Tokyo Medical Dental University Hospital, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
4. Department of Diagnostic Radiology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan
5. Department of Pulmonary Medicine, National Center for Global Health and Medicine, 1-21-1Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan
6. Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, 38 Morohongou, Moroyamamachi, Irumagun, Saitama, 350-0495, Japan
7. Kaneko Clinic, 305 Nishiaraijyuku, Kawaguchi, Saitama, 333-0083, Japan
8. Department of Respiratory Medicine, Social Insurance Central General Hospital, 3-22-1 Hyakunin-cho, Shinjyuku-ku, Tokyo, 169-0073, Japan
9. Gunma Rheumatism Clinic, 1040 Inomachi, Takasaki, Gunma, 370-0004, Japan
10. Department of Respiratory Medicine, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki, Gunma, 370-0829, Japan
11. Department of Allergy and Clinical Immunology, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8677, Japan
12. First Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
13. Tokyo Medical and Dental University Graduate School of Health Care Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
14. Nagara Orthopaedic Clinic, 3-10-12 Yashiro, Gifu-shi, Gifu, 502-0812, Japan
15. Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, 2-8-29 Musashidai, Fucyu-shi, Tokyo, 183-8524, Japan
16. Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, 3-39-15 Syowamachi, Maebashi-shi, Gunma, 371-8511, Japan
17. Center for Rheumatic Diseases, Chibaken Saiseikai Narashino Hospital, 1-1-1 Izumi-cho, Narashino, Chiba, 275-8580, Japan
18. Rheumatic Diseases Center, Kohnan Kakogawa Hospital, 1545-1 Kanno-cho-saijyo, Kakogawa, Hyogo, 675-8545, Japan
19. Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
20. Sekimachi Hospital, 1-6-19 Sekimachikita, Nerima-ku, Tokyo, 177-0051, Japan
21. Division of Hematology and Rheumatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchikami-cho, Itabashi-ku, Tokyo, 173-8610, Japan
22. Division of Rheumatology and Allergy, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan
23. Division of Rheumatology and Clinical Immunology, Department of Medicine Sapporo City General Hospital, Kita 11-jo, Nishi-13 Chome, Chuo-ku, Sapporo, 060-8604, Japan
24. Division of Rheumatology, Higashihiroshima Memorial Hospital, 2214 Saijyocyoyoshiyuki, Higashihiroshima, Hiroshima, 739-0002, Japan
25. The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
26. Global Center of Excellence (GCOE) Program, International Research Center for Molecular Science in Tooth and Bone Diseases, Tokyo Medical Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan - ISSN：1439-7609
文摘
Objectives To investigate the clinical characteristics and risk factors of Pneumocystis jirovecii pneumonia (PCP) in rheumatoid arthritis (RA) patients treated with adalimumab. Methods We conducted a multicenter, retrospective, caseontrol study to compare RA patients treated with adalimumab with and without PCP. Data from 17 RA patients who were diagnosed with PCP and from 89 RA patients who did not develop PCP during adalimumab treatment were collected. Results For the PCP patients, the median age was 68yearsold, with a median RA disease duration of eightyears. The median length of time from the first adalimumab injection to the development of PCP was 12weeks. At the onset of PCP, the median dosages of prednisolone and methotrexate were 5.0mg/day and 8.0mg/week, respectively. The patients with PCP were significantly older (p<0.05) and had more structural changes (p<0.05) than the patients without PCP. Computed tomography of the chest revealed ground-glass opacity without interlobular septal boundaries in the majority of the patients with PCP. Three PCP patients died. Conclusions 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.