Prognostic Factors Affecting Death in Patients with Rheumatoid Arthritis Complicated by Pneumocystis jirovecii Pneumonia and One-Year Clinical Course: The ANSWER Cohort Study

This multicenter retrospective study aimed to clarify the prognostic factors for mortality and changes in treatment modalities and disease activities after the onset of pneumonia (PCP) in patients with rheumatoid arthritis (RA). Data regarding the clinical background, treatment modalities, and disea...

Full description

Saved in:
Bibliographic Details
Published in:International journal of molecular sciences 2023-04, Vol.24 (8), p.7399
Main Authors: Shiba, Hideyuki, Kotani, Takuya, Nagai, Koji, Hata, Kenichiro, Yamamoto, Wataru, Yoshikawa, Ayaka, Wada, Yumiko, Hiramatsu, Yuri, Makino, Hidehiko, Ueda, Yo, Onishi, Akira, Murata, Koichi, Amuro, Hideki, Son, Yonsu, Hara, Ryota, Hirano, Toru, Ebina, Kosuke, Katayama, Masaki, Hashimoto, Motomu, Takeuchi, Tohru
Format: Article
Language:English
Subjects:
Aged
Arthritis, Rheumatoid - complications
Arthritis, Rheumatoid - drug therapy
Cohort Studies
Female
Humans
Male
Pneumocystis carinii
Pneumonia, Pneumocystis - complications
Pneumonia, Pneumocystis - drug therapy
Prednisolone - therapeutic use
Prognosis
Retrospective Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:This multicenter retrospective study aimed to clarify the prognostic factors for mortality and changes in treatment modalities and disease activities after the onset of pneumonia (PCP) in patients with rheumatoid arthritis (RA). Data regarding the clinical background, treatment modalities, and disease activity indicators of RA at the onset of PCP (baseline), and 6 months and 12 months after treatment were extracted. Of the 37 patients with RA-PCP (median age, 69 years; 73% female), chemical prophylaxis was administered to 8.1%. Six patients died during PCP treatment. The serum C-reactive protein (CRP) levels and the prednisolone (PDN) dose at baseline in the PCP death group were significantly higher than those in the survivor group. Multivariate analysis using a Cox regression model showed that PDN dose at baseline was a predictor of death from PCP in patients with RA. During the 12 months from baseline, the RA disease activity significantly decreased. A high dose of corticosteroids for RA may result in a poor prognosis when PCP is complicated. In the future, preventive administration techniques must be established for patients with RA who need PCP prevention.
ISSN:1422-0067
1422-0067
DOI:10.3390/ijms24087399