To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritis
Inflammatory rheumatic and musculoskeletal diseases, including systemic vasculitis, increase the risk of infection due to immunosuppressive treatments and disease-related immune dysfunction. In this viewpoint, we focused on patients with antineutrophil cytoplasmic antibody-associated vasculitis (AA...
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PAGEPress Publications
2025-02-01
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| Series: | Reumatismo |
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| Online Access: | https://www.reumatismo.org/reuma/article/view/1791 |
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| author | Alessandro Tomelleri Christian Dejaco Milena Bond |
| author_facet | Alessandro Tomelleri Christian Dejaco Milena Bond |
| author_sort | Alessandro Tomelleri |
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Inflammatory rheumatic and musculoskeletal diseases, including systemic vasculitis, increase the risk of infection due to immunosuppressive treatments and disease-related immune dysfunction. In this viewpoint, we focused on patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and giant cell arteritis (GCA). We critically reviewed the literature on infectious risks and the role of trimethoprim/sulfamethoxazole (TMP/SMX) as a prophylactic agent in these conditions. In AAV, serious infections from opportunistic (e.g., Pneumocystis jirovecii) and non-opportunistic pathogens are especially common, peaking in the first year post-diagnosis. TMP/SMX is crucial for prevention, as its use significantly reduces the incidence of Pneumocystis jirovecii pneumonia (PJP) and other serious infections. In GCA, although the risk of PJP is low, the overall infection risk is high and correlates with glucocorticoid dosage. However, evidence supporting the routine use of TMP/SMX in GCA is limited, warranting further investigation through randomized clinical trials.
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| format | Article |
| id | doaj-art-c3e571fe75ef44ea842e08d96b9c3d97 |
| institution | OA Journals |
| issn | 0048-7449 2240-2683 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Reumatismo |
| spelling | doaj-art-c3e571fe75ef44ea842e08d96b9c3d972025-08-20T02:13:45ZengPAGEPress PublicationsReumatismo0048-74492240-26832025-02-0110.4081/reumatismo.2025.1791To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritisAlessandro Tomelleri0https://orcid.org/0000-0002-5440-2078Christian Dejaco1https://orcid.org/0000-0002-0173-0668Milena Bond2https://orcid.org/0000-0002-5400-2955Unit of Immunology, Rheumatology, Allergy and Rare Diseases, San Raffaele Scientific Institute, MilanRheumatology, Hospital of Bruneck (ASAA-SABES), Teaching Hospital of the Paracelsius Medical University, Bruneck, Italy; Division of Rheumatology and Clinical Immunology, Department of Internal Medicine, Medical University, GrazRheumatology, Hospital of Bruneck (ASAA-SABES), Teaching Hospital of the Paracelsius Medical University, Bruneck Inflammatory rheumatic and musculoskeletal diseases, including systemic vasculitis, increase the risk of infection due to immunosuppressive treatments and disease-related immune dysfunction. In this viewpoint, we focused on patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) and giant cell arteritis (GCA). We critically reviewed the literature on infectious risks and the role of trimethoprim/sulfamethoxazole (TMP/SMX) as a prophylactic agent in these conditions. In AAV, serious infections from opportunistic (e.g., Pneumocystis jirovecii) and non-opportunistic pathogens are especially common, peaking in the first year post-diagnosis. TMP/SMX is crucial for prevention, as its use significantly reduces the incidence of Pneumocystis jirovecii pneumonia (PJP) and other serious infections. In GCA, although the risk of PJP is low, the overall infection risk is high and correlates with glucocorticoid dosage. However, evidence supporting the routine use of TMP/SMX in GCA is limited, warranting further investigation through randomized clinical trials. https://www.reumatismo.org/reuma/article/view/1791Vasculitisinfectionstrimethoprim-sulfamethoxazoleprophylaxisPneumocystis jirovecii |
| spellingShingle | Alessandro Tomelleri Christian Dejaco Milena Bond To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritis Reumatismo Vasculitis infections trimethoprim-sulfamethoxazole prophylaxis Pneumocystis jirovecii |
| title | To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritis |
| title_full | To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritis |
| title_fullStr | To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritis |
| title_full_unstemmed | To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritis |
| title_short | To prophylax or not to prophylax? The role of trimethoprim/sulfamethoxazole as a prophylactic agent in systemic vasculitis: the case of antineutrophil cytoplasmic antibody- associated vasculitis and giant cell arteritis |
| title_sort | to prophylax or not to prophylax the role of trimethoprim sulfamethoxazole as a prophylactic agent in systemic vasculitis the case of antineutrophil cytoplasmic antibody associated vasculitis and giant cell arteritis |
| topic | Vasculitis infections trimethoprim-sulfamethoxazole prophylaxis Pneumocystis jirovecii |
| url | https://www.reumatismo.org/reuma/article/view/1791 |
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