PMID- 22466117
OWN - NLM
STAT- MEDLINE
DCOM- 20130613
LR  - 20161125
IS  - 1439-7609 (Electronic)
IS  - 1439-7595 (Linking)
VI  - 23
IP  - 1
DP  - 2013 Jan
TI  - Positivity for anti-RNP antibody is a risk factor for adverse effects caused by 
      trimethoprim-sulfamethoxazole, a prophylactic agent for P. jiroveci pneumonia, in 
      patients with connective tissue diseases.
PG  - 62-70
LID - 10.1007/s10165-012-0625-x [doi]
AB  - OBJECTIVES: Trimethoprim-sulphamethoxazole (TMP-STX), an agent used for 
      prophylaxis against pneumocystis pneumonia (PCP) in immunocompromised hosts, 
      causes serious adverse effects (AEs) in some patients. The objective of this 
      study was to identify the risk factors for AEs caused by TMP-STX in connective 
      tissue disease (CTD) patients and to describe the clinical features of the AEs. 
      METHODS: The medical records of 539 patients (CTDs 312, pulmonary diseases 227) 
      receiving TMP-STX for prophylaxis against PCP were reviewed retrospectively. 
      Patients with human immunodeficiency virus were excluded. Univariate and 
      multivariate analyses were conducted to identify the risk factors. RESULTS: 
      Adverse events caused by TMP-STX occurred in 22 of 312 (7.05 %) CTD patients, 
      while only six of 227 (2.64 %) pulmonary disease patients developed AEs. The 
      incidence of AEs was significantly higher in systemic lupus erythematosus (SLE) 
      (11.0 %) and mixed connective tissue disease (MCTD) (33.3 %) patients than in 
      other CTD patients. AEs occurred in 25 % of patients with anti-RNP antibody. 
      Univariate analysis revealed that SLE, MCTD, and anti-RNP antibody were risk 
      factors for AEs in CTD patients. Further multivariate analyses demonstrated that 
      only anti-RNP antibody positivity was a risk factor for AEs. Systemic 
      inflammation, including fever, was a characteristic manifestation of the AEs in 
      CTD patients, particularly those with anti-RNP antibody. CONCLUSIONS: Positivity 
      for anti-RNP antibody is a risk factor for AEs caused by TMP-STX in CTD patients. 
      Systemic inflammation, including fever, might be a characteristic feature of the 
      AEs in CTD patients, particularly those with anti-RNP antibody.
FAU - Maezawa, Reika
AU  - Maezawa R
AD  - Clinical Immunology, Dokkyo Medical University, 880 Kita-Kobayashi, Mibu, 
      Tochigi, 321-0293, Japan.
FAU - Kurasawa, Kazuhiro
AU  - Kurasawa K
FAU - Arai, Satoko
AU  - Arai S
FAU - Okada, Harutsugu
AU  - Okada H
FAU - Owada, Takayoshi
AU  - Owada T
FAU - Fukuda, Takeshi
AU  - Fukuda T
LA  - eng
PT  - Journal Article
DEP - 20120331
PL  - England
TA  - Mod Rheumatol
JT  - Modern rheumatology
JID - 100959226
RN  - 0 (Anti-Infective Agents)
RN  - 0 (Antibodies, Antinuclear)
RN  - 0 (Ribonucleoproteins)
RN  - 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
SB  - IM
MH  - Aged
MH  - Anti-Infective Agents/*adverse effects
MH  - Antibiotic Prophylaxis/*adverse effects
MH  - Antibodies, Antinuclear/*blood
MH  - *Connective Tissue Diseases/blood/complications/drug therapy
MH  - Female
MH  - Humans
MH  - *Lung Diseases/blood/complications/drug therapy
MH  - Male
MH  - Middle Aged
MH  - Pneumocystis carinii/drug effects
MH  - Pneumonia, Pneumocystis/complications/prevention & control
MH  - Retrospective Studies
MH  - Ribonucleoproteins/*immunology
MH  - Risk Factors
MH  - Trimethoprim, Sulfamethoxazole Drug Combination/*adverse effects
EDAT- 2012/04/03 06:00
MHDA- 2013/06/14 06:00
CRDT- 2012/04/03 06:00
PHST- 2011/11/24 00:00 [received]
PHST- 2012/02/15 00:00 [accepted]
PHST- 2012/04/03 06:00 [entrez]
PHST- 2012/04/03 06:00 [pubmed]
PHST- 2013/06/14 06:00 [medline]
AID - 10.1007/s10165-012-0625-x [doi]
PST - ppublish
SO  - Mod Rheumatol. 2013 Jan;23(1):62-70. doi: 10.1007/s10165-012-0625-x. Epub 2012 
      Mar 31.