Infecciones y esclerosis sistémica: un desafío emergente

Revista Colombiana de Reumatología - Tập 27 - Trang 62-84 - 2020
Julián E. Barahona-Correa1,2, Alejandro De la Hoz1, María José López1, Javier Garzón1,3, Yannick Allanore4, Gerardo Quintana-López2,5
1División de Enfermedades Infecciosas, Hospital Universitario San Ignacio, Bogotá, Colombia
2Grupo Reumavance, División de Reumatología, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia
3Departamento de Medicina Interna, Pontificia Universidad Javeriana, Bogotá, Colombia
4Servicio de Reumatología, centro de referencia de enfermedades autoinmunes sistémicas raras, INSERM U1016, Instituto Cochin, Hospital Cochin, Paris, Francia
5Unidad de Reumatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia

Tài liệu tham khảo

Rongioletti, 2018, Scleroderma with an update about clinico-pathological correlation, G Ital Dermatol Venereol., 153, 208 Prada, 2018, Esclerosis sistémica, 493 Denton, 2017, Systemic sclerosis, Lancet., 390, 1685, 10.1016/S0140-6736(17)30933-9 Mok, 2011, Life expectancy, standardized mortality ratios, and causes of death in six rheumatic diseases in Hong Kong, China, Arthritis Rheum., 63, 1182, 10.1002/art.30277 Bussone, 2009, Infectious complications of systemic sclerosis, Presse Med., 38, 291, 10.1016/j.lpm.2008.11.003 Allanore, 2016, Clinical characteristics and predictors of gangrene in patients with systemic sclerosis and digital ulcers in the Digital Ulcer Outcome Registry: a prospective, observational cohort, Ann Rheum Dis., 75, 1736, 10.1136/annrheumdis-2016-209481 Giuggioli, 2013, Osteomyelitis complicating scleroderma digital ulcers, Clin Rheumatol., 32, 623, 10.1007/s10067-012-2161-7 Rahal, 2013, Infections during rheumatic diseases: A serie of 146 patients, Ann Rheum Dis., 71, 700, 10.1136/annrheumdis-2012-eular.1084 Fernández-Codina, 2018, Treatment algorithms for systemic sclerosis according to experts, Arthritis Rheumatol., 70, 1820, 10.1002/art.40560 Kowal-Bielecka, 2017, Update of EULAR recommendations for the treatment of systemic sclerosis, Ann Rheum Dis., 76, 1327, 10.1136/annrheumdis-2016-209909 Smith, 2018, Systemic sclerosis: State of the art on clinical practice guidelines, RMD Open., 4, e000782, 10.1136/rmdopen-2018-000782 Pellar, 2017, Evidence-based management of systemic sclerosis: Navigating recommendations and guidelines, Semin Arthritis Rheum., 46, 767, 10.1016/j.semarthrit.2016.12.003 Bruni, 2017, Use of biologics and other novel therapies for the treatment of systemic sclerosis, Expert Rev Clin Immunol., 13, 469, 10.1080/1744666X.2017.1263153 Elhai, 2012, Trends in mortality in patients with systemic sclerosis over 40 years: A systematic review and meta-analysis of cohort studies, Rheumatology (Oxford)., 51, 1017, 10.1093/rheumatology/ker269 Tyndall, 2010, Causes and risk factors for death in systemic sclerosis: a study from the EULAR Scleroderma Trials and Research (EUSTAR) database, Ann Rheum Dis., 69, 1809, 10.1136/ard.2009.114264 Hu, 2018, Prognostic profile of systemic sclerosis: analysis of the clinical EUSTAR cohort in China, Arthritis Res Ther., 20, 235, 10.1186/s13075-018-1735-4 Netwijitpan, 2013, Indications for hospitalization and in-hospital mortality in Thai systemic sclerosis, Clin Rheumatol., 32, 361, 10.1007/s10067-012-2131-0 Piga, 2016, Population-based analysis of hospitalizations for patients with systemic sclerosis in a West-European region over the period 2001-2012, Rheumatol Int., 36, 73, 10.1007/s00296-015-3330-1 Komócsi, 2012, The impact of cardiopulmonary manifestations on the mortality of SSC: a systematic review and meta-analysis of observational studies, Rheumatology (Oxford)., 51, 1027, 10.1093/rheumatology/ker357 Sampaio-Barros, 2012, Survival, causes of death, and prognostic factors in systemic sclerosis: analysis of 947 Brazilian patients, J Rheumatol., 39, 1971, 10.3899/jrheum.111582 Shenavandeh, 2017, Assessment of hospitalization and mortality of scleroderma in-patients: a thirteen-year study, Reumatologia., 55, 163, 10.5114/reum.2017.69776 Steen, 2007, Changes in causes of death in systemic sclerosis, 1972-2002, Ann Rheum Dis., 66, 940, 10.1136/ard.2006.066068 de Rezende, 2017, Distinct mortality profile in systemic sclerosis: a death certificate study in Rio de Janeiro Brazil (2006-2015) using a multiple causes of death analysis, Clin Rheumatol., 38, 1 Elhai, 2017, Mapping and predicting mortality from systemic sclerosis, Ann Rheum Dis., 76, 1897, 10.1136/annrheumdis-2017-211448 Sehra, 2016, Predictors of inpatient mortality in patients with systemic sclerosis: a case control study, Clin Rheumatol., 35, 1631, 10.1007/s10067-016-3245-6 Chung, 2007, Hospitalizations and mortality in systemic sclerosis: results from the Nationwide Inpatient Sample, Rheumatology., 46, 1808, 10.1093/rheumatology/kem273 Rubio-Rivas, 2014, Mortality and survival in systemic sclerosis: systematic review and meta-analysis, Semin Arthritis Rheum., 44, 208, 10.1016/j.semarthrit.2014.05.010 Li, 2018, Survival rate, causes of death, and risk factors in systemic sclerosis: a large cohort study, Clin Rheumatol., 37, 3051, 10.1007/s10067-018-4291-z Ram Poudel, 2018, Mortality, length of stay and cost of hospitalization among patients with systemic sclerosis: results from the National Inpatient Sample, Rheumatology., 57, 1611, 10.1093/rheumatology/key150 Foocharoen, 2012, Incidence rate and causes of infection in Thai systemic sclerosis patients, Int J Rheum Dis., 15, 277, 10.1111/j.1756-185X.2012.01728.x Khanna, 2016, Safety and efficacy of subcutaneous tocilizumab in adults with systemic sclerosis (faSScinate): a phase 2, randomised, controlled trial, Lancet., 387, 2630, 10.1016/S0140-6736(16)00232-4 Khanna, 2018, Efficacy and safety of tocilizumab for the treatment of systemic sclerosis: results from a phase 3 randomized controlled trial [abstract], Arthritis Rheumatol., 70, 898 Khanna, 2018, Abatacept Vs. placebo in early diffuse cutaneous systemic sclerosis—results of a phase 2 investigator initiated, double-blind, placebo-controlled, multicenter, randomized controlled trial study [abstract], Arthritis Rheumatol., 70, 900 Mouthon, 2013, Impact of recurrent ischemic digital ulcers on hand disability in systemic sclerosis, Ann Rheum Dis., 71, 71, 10.1136/annrheumdis-2012-eular.2202 Nihtyanova, 2008, Clinical burden of digital vasculopathy in limited and diffuse cutaneous systemic sclerosis, Ann Rheum Dis., 67, 120, 10.1136/ard.2007.072686 Vonk, 2011, Burden of disease in Dutch patients with systemic sclerosis and digital ulcers; data from thedata from the Dutch national registry, Arthritis Rheum., 63 Bernardo Cofiño, 2014, Superinfected calcinosis cutis as a presentation of a limited form systemic sclerosis, Reumatol Clin., 10, 187, 10.1016/j.reuma.2013.07.003 Tangri, 2006, Soft-tissue infection and underlying calcinosis of CREST syndrome, CMAJ., 175, 1059, 10.1503/cmaj.060521 Minor, 1988, Pyomyositis in a patient with progressive systemic sclerosis Case report and review of the literature, Arch Intern Med., 148, 1453, 10.1001/archinte.1988.00380060217039 Mok, 2006, Necrotizing fasciitis in rheumatic diseases, Lupus., 15, 380, 10.1191/0961203306lu2314cr Amanzi, 2010, Digital ulcers in systemic sclerosis: staging, characteristics and sub-setting through observation of 1614 digital lesions, Rheumatology., 49, 1374, 10.1093/rheumatology/keq097 Chiapparoli, 2018, Osteomyelitis complicating digital ulcers in systemic sclerosis, Ann Rheum Dis., 77, 1519 Braun-Moscovici, 2017, The prevalence of osteomyelitis in infected digital ulcers in systemic sclerosis patients, Ann Rheum Dis., 76, 910 Mouthon, 2012, Evaluation of the impact of recurrent ischaemic digital ulcers on hand disability in patients with SSc (eclipse)-report of the cohort at the time of inclusion, Rheumatology., 51 Giuggioli, 2012, Scleroderma digital ulcers complicated by infection with fecal pathogens, Arthritis Care Res (Hoboken)., 64, 295, 10.1002/acr.20673 Cimino, 2015, Current approach to digital ulcers in systemic sclerosis patients, Ital J Med., 9, 24 Tägil, 2007, Wound healing after hand surgery in patients with systemic sclerosis--a retrospective analysis of 41 operations in 19 patients, J Hand Surg Eur Vol., 32, 316, 10.1016/J.JHSB.2006.12.006 Low, 2010, Disease manifestations and pulmonary complications in Asian patients with systemic sclerosis, Int J Rheum Dis., 13, 189 Stevens, 2012, Lung disease is the major cause of death in the Australian SSc cohort study, Rheumatology., 51, ii58 Tanaka, 2015, Pulmonary infections following immunosuppressive treatments during hospitalization worsen the short-term vital prognosis for patients with connective tissue disease-associated interstitial pneumonia, Mod Rheumatol., 25, 609, 10.3109/14397595.2014.980384 Di Franco, 2017, Lung infections in systemic rheumatic disease: focus on opportunistic infections, Int J Mol Sci., 18, 293, 10.3390/ijms18020293 Farber, 2010, Care of patients with scleroderma in the intensive care setting, J Intensive Care Med., 25, 247, 10.1177/0885066610371181 Shi, 2013, Procalcitonin kinetics: a reliable tool for diagnosis and monitoring of the course of bacterial infection in critically ill patients with autoimmune diseases, Intensive Care Med., 39, 2233, 10.1007/s00134-013-3103-9 Sleglova, 2010, Usefulness of procalcitonin measurement in differentiating between activity of systemic autoimmune disease and bacterial infection, Arthritis Rheum., 62, 687 Marie, 2001, Esophageal involvement and pulmonary manifestations in systemic sclerosis, Arthritis Rheum., 45, 346, 10.1002/1529-0131(200108)45:4<346::AID-ART347>3.0.CO;2-L Zhang, 2013, Association of gastroesophageal factors and worsening of forced vital capacity in systemic sclerosis, J Rheumatol., 40, 850, 10.3899/jrheum.120705 Ou, 2014, Systemic sclerosis and the risk of tuberculosis, J Rheumatol., 41, 1662, 10.3899/jrheum.131125 Lu, 2015, Increased risk of pulmonary and extra-pulmonary tuberculosis in patients with rheumatic diseases, Int J Tuberc Lung Dis., 19, 1500, 10.5588/ijtld.15.0087 Ahmad, 2008, Increased incidence of tuberculosis in patients of systemic sclerosis on dexamethasone pulse therapy: a short communication from Kashmir, Indian J Dermatol., 53, 24, 10.4103/0019-5154.39737 Valence, 2015, Association of tuberculosis and deep venous thromboembolism in patients with autoimmune diseases, Eur J Intern Med., 26, e23, 10.1016/j.ejim.2015.04.011 Escobedo, 2016, Central nervous system tuberculosis in patients with systemic rheumatic disease that were receiving immunosuppresive therapy, Neurology., 86 Mizutani, 2016, Silica exposure, silicosis, autoimmune diseases, tuberculosis and nontuberculous pulmonary mycobacterial disease, Eur Respir J., 48, PA1171 Shimizu, 2005, (1→3)-Beta-D glucan is a diagnostic and negative prognostic marker for Pneumocystis carinii pneumonia in patients with connective tissue disease, Clin Exp Rheumatol., 23, 678 Ogawa, 2005, Prediction of and prophylaxis against Pneumocystis pneumonia in patients with connective tissue diseases undergoing medium- or high-dose corticosteroid therapy, Mod Rheumatol., 15, 91, 10.3109/PL00021707 Mecoli, 2017, Pneumocystis jiroveci pneumonia in rheumatic disease: a 20-year single-centre experience, Clin Exp Rheumatol., 35, 671 Tsai, 2011, Opportunistic pulmonary infection in patients with connective tissue disease: a single-center experience, Chest., 140, 756A, 10.1378/chest.1117845 Winthrop, 2018, Pneumocystis and glucocorticoid use: to prophylax or not to prophylax (and when?); that is the question, Ann Rheum Dis., 77, 631, 10.1136/annrheumdis-2017-212588 Nandi, 2015, Interstitial lung disease in systemic scleroderma, complicated with bilateral pulmonary aspergilloma: an unusual association, J Clin Diagnostic Res., 9, OC11 Marie, 2008, Pulmonary actinomycosis in a patient with diffuse systemic sclerosis treated with infliximab, QJM., 101, 419, 10.1093/qjmed/hcn028 Pittman, 2018, Treatment of small intestinal bacterial overgrowth in systemic sclerosis: a systematic review, Rheumatology (Oxford)., 57, 1802, 10.1093/rheumatology/key175 Emmanuel, 2016, Current management of the gastrointestinal complications of systemic sclerosis, Nat Rev Gastroenterol Hepatol., 13, 461, 10.1038/nrgastro.2016.99 Rodríguez-Varón, 2017, Antibiotic-associated diarrhea: clinical characteristics and the presence of clostridium difficile, Rev Gastroenterol Mex., 82, 129 Gualtero, 2017, [Characteristics of clostridium difficile infection in a high complexity hospital and report of the circulation of the NAP1/027 hypervirulent strain in Colombia], Biomedica., 37, 466, 10.7705/biomedica.v37i4.3244 Alcalá Hernández, 2017, Clostridium difficile infection, Med Clin (Barc)., 148, 456, 10.1016/j.medcli.2017.01.033 Hendel, 1988, Esophageal candidosis in progressive systemic sclerosis: occurrence, significance, and treatment with fluconazole, Scand J Gastroenterol., 23, 1182, 10.3109/00365528809090188 Geirsson, 1989, Cineradiography identifies esophageal candidiasis in progressive systemic sclerosis, Clin Exp Rheumatol., 7, 43 Yong, 2018, Helicobacter pylori infection in systemic sclerosis: a systematic review and meta-analysis of observational studies, Clin Exp Rheumatol., 36, 168 Radic, 2014, Eradication of Helicobacter pylori reduces disease severity and activity in systemic sclerosis patients, Eur J Clin Invest., 44, 64 Balaji, 2017, Helicobacter Pylori infection in systemic sclerosis and its association with upper gastrointestinal dysfunction, Indian J Rheumatol., 12, 204, 10.4103/injr.injr_62_17 Laserna, 2018, Treatment of the Helicobacter pylori infection: a critical appraisal of the literature, Univ Med., 59, 45 Endo, 2010, Long-term home parenteral nutrition therapy in eleven patients with severe scleroderma bowel disease, Int J Rheum Dis., 13, 183 Harrison, 2015, Long-term outcome of patients with systemic sclerosis requiring home parenteral nutrition, Clin Nutr., 34, 991, 10.1016/j.clnu.2014.11.002 Winthrop, 2015, Opportunistic infections and biologic therapies in immune-mediated inflammatory diseases: consensus recommendations for infection reporting during clinical trials and postmarketing surveillance, Ann Rheum Dis., 74, 2107, 10.1136/annrheumdis-2015-207841 Ito, 1994, An autopsy case of progressive systemic sclerosis with disseminated Candida albicans embolism, Japanese J Rheumatol., 5, 363 Sripavatakul, 2011, Spontaneous pneumothorax from cryptococcal pneumonia in systemic sclerosis: a case report, J Med Case Rep., 5, 309, 10.1186/1752-1947-5-309 Ishikawa, 2012, Primary cutaneous cryptococcosis in a patient with CREST syndrome, Eur J Dermatol., 22, 421, 10.1684/ejd.2012.1684 Bamford, 1975, Toxoplasmosis mimicking a brain abscess in an adult with treated scleroderma, Neurology., 25, 343, 10.1212/WNL.25.4.343 Gerster, 2004, Tenosynovitis of the hands caused by Mycobacterium kansasii in a patient with scleroderma, J Rheumatol., 31, 2523 Cantwell, 1966, Scleroderma with ulceration secondary to atypical mycobacteria, Arch Dermatol., 94, 663, 10.1001/archderm.94.5.663 Napier, 1993, Atypical mycobacterial infection in a case of systemic sclerosis, Indian J Dermatol Venereol Leprol., 59, 33 Auzary, 1999, Localized subcutaneous Nocardia farcinica abscess in a woman with overlap syndrome between systemic scleroderma and polymyositis, Ann Med Interne (Paris)., 150, 582 Mehta, 2015, Pulmonary nocardia farcinica infection in a patient with scleroderma-associated interstitial lung disease, Am J Respir Crit Care Med., 191, A1834 Amathieu, 2007, [Splenic rupture associated with CMV infection: case report and review], Ann Fr Anesth Reanim., 26, 674, 10.1016/j.annfar.2007.03.037 Contreras, 2001, Cytomegalovirus esophagitis as a treatable complication of systemic sclerosis, J Clin Rheumatol., 7, 384, 10.1097/00124743-200112000-00007 Ozaki, 2013, Cytomegalovirus disease of the upper gastrointestinal tract in patients with rheumatic diseases: a case series and literature review, Clin Rheumatol., 32, 1683, 10.1007/s10067-013-2363-7 Ciervo, 2015, A rare case of cytomegalovirus pancreatitis in a woman with new onset systemic sclerosis, Ital J Med., 9, 23 Broccolo, 2013, Selective reactivation of human herpesvirus 6 in patients with autoimmune connective tissue diseases, J Med Virol., 85, 1925, 10.1002/jmv.23670 Michailidou, 2016, Acute Necrotizing Herpetic Pleuritis in a Patient with Systemic Sclerosis and Immunosuppression: Report of a Novel Pulmonary Herpes Infection, Am J Med., 129, e25, 10.1016/j.amjmed.2015.09.005 Ghinoi, 2005, Coexistence of non-specific and usual interstitial pneumonia in a patient with severe cystic scleroderma lung involvement and parvovirus B19 infection, Clin Exp Rheumatol., 23, 431 Yamaguchi, 2001, Guillain-Barré syndrome following herpes zoster in a patient with systemic sclerosis, Mod Rheumatol., 11, 251, 10.3109/s101650170014 Zingarelli, 2008, Prophylaxis and therapy of HBV infection in 20 patients treated with disease modifying antirheumatic drugs or with biological agents for rheumatic diseases, Reumatismo., 60, 22 Koutsianas, 2017, Hepatitis B Reactivation in Rheumatic Diseases: Screening and Prevention, Rheum Dis Clin North Am., 43, 133, 10.1016/j.rdc.2016.09.012 Martin, 2014, Screening of human papillomavirus infection in women with systemic sclerosis, Clin Exp Rheumatol., 32 Vacchi, 2017, Persistence of human papillomavirus in the cervix of women with systemic sclerosis, Ann Rheum Dis., 76, 1267 Wingard, 2010, Hematopoietic stem cell transplantation: an overview of infection risks and epidemiology, Infect Dis Clin North Am., 24, 257, 10.1016/j.idc.2010.01.010 Bertrand, 2017, Kidney transplantation in patients with systemic sclerosis: a nationwide multicentre study, Transpl Int., 30, 256, 10.1111/tri.12923 Gadre, 2017, Lung or heart-lung transplant in pulmonary arterial hypertension: what is the impact of systemic sclerosis?, Exp Clin Transplant, 15, 676 Lenaerts, 2018, Cardiac transplantation in systemic sclerosis: single-centre experience of three cases, Rheumatology (Oxford)., 57, 1120, 10.1093/rheumatology/key048 Jablonski, 2018, Lung transplantation in scleroderma: recent advances and lessons, Curr Opin Rheumatol., 30, 562, 10.1097/BOR.0000000000000546 Green, 2019, Foreword: 4th edition of the American Society of Transplantation Infectious Diseases Guidelines, Clin Transplant., 33, e13642, 10.1111/ctr.13642 Flórez-Suárez, 2018, Inmunosupresores, 221 Iudici, 2015, Low-dose pulse cyclophosphamide in interstitial lung disease associated with systemic sclerosis (SSc-ILD): efficacy of maintenance immunosuppression in responders and non-responders, Semin Arthritis Rheum., 44, 437, 10.1016/j.semarthrit.2014.09.003 Barnes, 2018, Cyclophosphamide for connective tissue disease-associated interstitial lung disease, Cochrane database Syst Rev., 1, CD010908 Tashkin, 2006, Cyclophosphamide versus placebo in scleroderma lung disease, N Engl J Med., 354, 2655, 10.1056/NEJMoa055120 Hoyles, 2006, A multicenter, prospective, randomized, double-blind, placebo-controlled trial of corticosteroids and intravenous cyclophosphamide followed by oral azathioprine for the treatment of pulmonary fibrosis in scleroderma, Arthritis Rheum., 54, 3962, 10.1002/art.22204 Zhang, 2015, [Randomized control multi-center clinical study of mycophenolate mofetil and cyclophosphamide in the treatment of connective tissue disease related interstitial lung disease], Zhonghua Yi Xue Za Zhi., 95, 3641 Tashkin, 2016, Mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II): a randomised controlled, double-blind, parallel Group trial, Lancet Respir Med., 4, 708, 10.1016/S2213-2600(16)30152-7 Poormoghim, 2012, Cyclophosphamide for scleroderma lung disease: a systematic review and meta-analysis, Rheumatol Int., 32, 2431, 10.1007/s00296-011-1967-y Masserini, 2014, Bkvirus associated haemorrhagic cystitis in a scleroderma patient after cyclophosphamide therapy, Clin Exp Rheumatol., 32, S140 Nakamura, 2018, Autologous haematopoietic stem cell transplantation for Japanese patients with systemic sclerosis: long-term follow-up on a phase II trial and treatment-related fatal cardiomyopathy, Mod Rheumatol., 28, 879, 10.1080/14397595.2017.1416920 Woytala, 2016, The safety of intravenous cyclophosphamide in the treatment of rheumatic diseases, Adv Clin Exp Med., 25, 479, 10.17219/acem/28736 Alarcón, 1997, Relative risk and attributable risk needed to interpret «factors predictive of infection in cyclophosphamide-treated lupus patients»: comment on the article by Pryor et al, Arthritis Rheum., 40, 1186 Pryor, 1996, Risk factors for serious infection during treatment with cyclophosphamide and high-dose corticosteroids for systemic lupus erythematosus, Arthritis Rheum., 39, 1475, 10.1002/art.1780390906 Santamaría-Alza, 2018, Invasive fungal infections in Colombian patients with systemic lupus erythematosus, Lupus., 27, 1116, 10.1177/0961203318763743 Molloy, 2017, The risk of progressive multifocal leukoencephalopathy in the biologic era: prevention and management, Rheum Dis Clin North Am., 43, 95, 10.1016/j.rdc.2016.09.009 Chakravarty, 2017, Incidence and prevention of herpes zoster reactivation in patients with autoimmune diseases, Rheum Dis Clin North Am., 43, 111, 10.1016/j.rdc.2016.09.010 Droz, 2013, Kinetic profiles and management of hepatitis B virus reactivation in patients with immune-mediated inflammatory diseases, Arthritis Care Res (Hoboken)., 65, 1504, 10.1002/acr.21990 Ueda, 2018, Mycophenolate mofetil as a therapeutic agent for interstitial lung diseases in systemic sclerosis, Respir Investig., 56, 14, 10.1016/j.resinv.2017.11.004 Omair, 2015, Safety and effectiveness of mycophenolate in systemic sclerosis. A systematic review, PLoS One., 10, e0124205, 10.1371/journal.pone.0124205 Boulos, 2017, Long-term efficacy and tolerability of mycophenolate mofetil therapy in diffuse scleroderma skin disease, Int J Rheum Dis., 20, 481, 10.1111/1756-185X.13035 Gordon, 2018, Belimumab for the treatment of early diffuse systemic sclerosis: results of a randomized, double-blind, placebo-controlled, pilot trial, Arthritis Rheumatol., 70, 308, 10.1002/art.40358 Naidu, 2018, A randomised controlled trial to compare the efficacy of oral mycophenolate mofetil with placebo in patients with systemic sclerosis related early interstitial lung disease, Ann Rheum Dis., 77, 751 Patel, 2019, The expanding field of secondary antibody deficiency: causes, diagnosis, and management, Front Immunol., 10, 33, 10.3389/fimmu.2019.00033 Tunnicliffe, 2018, Immunosuppressive treatment for proliferative lupus nephritis, Cochrane database Syst Rev., 6, CD002922 Toruner, 2008, Risk factors for opportunistic infections in patients with inflammatory bowel disease, Gastroenterology., 134, 929, 10.1053/j.gastro.2008.01.012 Present, 1989, 6-Mercaptopurine in the management of inflammatory bowel disease: short- and long-term toxicity, Ann Intern Med., 111, 641, 10.7326/0003-4819-111-8-641 Glazier, 2005, The ten-year single-center experience with 6-mercaptopurine in the treatment of inflammatory bowel disease, J Clin Gastroenterol., 39, 21 McLean, 2014, Adverse events in IBD: to stop or continue immune suppressant and biologic treatment, Expert Rev Gastroenterol Hepatol., 8, 223, 10.1586/17474124.2014.881715 Restrepo, 2016, Farmacogenética del metotrexato en artritis reumatoide Revisión sistemática, Rev Colomb Reumatol., 23, 102 Su, 2009, Rapamycin versus methotrexate in early diffuse systemic sclerosis: results from a randomized, single-blind pilot study, Arthritis Rheum., 60, 3821, 10.1002/art.24986 Krishna Sumanth, 2007, Evaluation of oral methotrexate in the treatment of systemic sclerosis, Int J Dermatol., 46, 218, 10.1111/j.1365-4632.2007.02887.x Pope, 2001, A randomized, controlled trial of methotrexate versus placebo in early diffuse scleroderma, Arthritis Rheum., 44, 1351, 10.1002/1529-0131(200106)44:6<1351::AID-ART227>3.0.CO;2-I van den Hoogen, 1996, Comparison of methotrexate with placebo in the treatment of systemic sclerosis: a 24 week randomized double-blind trial, followed by a 24 week observational trial, Br J Rheumatol., 35, 364, 10.1093/rheumatology/35.4.364 Bernatsky, 2007, Anti-rheumatic drug use and risk of serious infections in rheumatoid arthritis, Rheumatology., 46, 1157, 10.1093/rheumatology/kem076 McLean-Tooke, 2009, Methotrexate, rheumatoid arthritis and infection risk: what is the evidence?, Rheumatology (Oxford)., 48, 867, 10.1093/rheumatology/kep101 Fareau, 2007, Hypercortisolemia and infection, Infect Dis Clin North Am., 21, 639, 10.1016/j.idc.2007.06.001 Iudici, 2017, What should clinicians know about the use of glucocorticoids in systemic sclerosis?, Mod Rheumatol., 27, 919, 10.1080/14397595.2016.1270796 Youssef, 2016, Infection Risk and Safety of Corticosteroid Use, Rheum Dis Clin North Am., 42, 157, 10.1016/j.rdc.2015.08.004 Migita, 2013, Glucocorticoid therapy and the risk of infection in patients with newly diagnosed autoimmune disease, Medicine (Baltimore)., 92, 285, 10.1097/MD.0b013e3182a72299 Migita, 2013, Rates of serious intracellular infections in autoimmune disease patients receiving initial glucocorticoid therapy, PLoS One., 8, e78699, 10.1371/journal.pone.0078699 Barahona-Correa, 2018, Comparison of plasma cytokine levels before and after treatment with rituximab in patients with rheumatoid arthritis and systemic lupus erythematosus-associated polyautoimmunity, Univ Med., 59, 1, 10.11144/Javeriana.umed59-3.cyto Fraticelli, 2018, Combination therapy with rituximab and mycophenolate mofetil in systemic sclerosis. A single-centre case series study, Clin Exp Rheumatol., 36, S142 Thiebaut, 2018, Efficacy and safety of rituximab in systemic sclerosis: French retrospective study and literature review, Autoimmun Rev., 17, 582, 10.1016/j.autrev.2017.12.010 Melsens, 2018, Two years follow-up of an open-label pilot study of treatment with rituximab in patients with early diffuse cutaneous systemic sclerosis, Acta Clin Belg., 73, 119, 10.1080/17843286.2017.1372244 Elhai, 2018, Rituximab in systemic sclerosis: safety and efficacy data from the eustar network, Ann Rheum Dis., 77, 122 Christou, 2017, Risk factors predisposing to the development of hypogammaglobulinemia and infections post-Rituximab, Int Rev Immunol., 36, 352, 10.1080/08830185.2017.1346092 Mikulska, 2018, ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Agents targeting lymphoid cells surface antigens [I]: CD19 CD20 and CD52), Clin Microbiol Infect., 24, S71, 10.1016/j.cmi.2018.02.003 Tudesq, 2018, Clinical and microbiological characteristics of the infections in patients treated with rituximab for autoimmune and/or malignant hematological disorders, Autoimmun Rev., 17, 115, 10.1016/j.autrev.2017.11.015 Kelesidis, 2011, Does rituximab increase the incidence of infectious complications? A narrative review, Int J Infect Dis., 15, e2, 10.1016/j.ijid.2010.03.025 Perrillo, 2015, American Gastroenterological Association Institute technical review on prevention and treatment of hepatitis B virus reactivation during immunosuppressive drug therapy, Gastroenterology., 148, 221, 10.1053/j.gastro.2014.10.038 Jauregui, 2018, Agentes biológicos no anti-TNF y pequeñas moléculas, 253 Distler, 2016, Tocilizumab for systemic sclerosis: implications for future trials, Lancet., 387, 2580, 10.1016/S0140-6736(16)00622-X Manabe, 2017, Necrotising soft tissue infection without systemic toxicity in a patient with rheumatoid arthritis treated with tocilizumab, BMJ Case Rep., 2017 Nguyen, 2013, Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab, BMJ Case Rep., 2013, 10.1136/bcr-2012-007413 Kobayashi, 2015, Mycobacterium abscessus pulmonary infection under treatment with tocilizumab, Intern Med., 54, 1309, 10.2169/internalmedicine.54.3956 Koike, 2014, Effectiveness and safety of tocilizumab: postmarketing surveillance of 7901 patients with rheumatoid arthritis in Japan, J Rheumatol., 41, 15, 10.3899/jrheum.130466 Moots, 2017, Effect of tocilizumab on neutrophils in adult patients with rheumatoid arthritis: pooled analysis of data from phase 3 and 4 clinical trials, Rheumatology (Oxford)., 56, 541 Winthrop, 2018, Clin Microbiol Infect., 24, S21, 10.1016/j.cmi.2018.02.002 Chakravarty, 2015, Gene expression changes reflect clinical response in a placebo-controlled randomized trial of abatacept in patients with diffuse cutaneous systemic sclerosis, Arthritis Res Ther., 17, 159, 10.1186/s13075-015-0669-3 Elhai, 2013, Outcomes of patients with systemic sclerosis-associated polyarthritis and myopathy treated with tocilizumab or abatacept: a EUSTAR observational study, Ann Rheum Dis., 72, 1217, 10.1136/annrheumdis-2012-202657 Tank, 2017, Biological response modifiers in rheumatoid arthritis: systematic review and meta-analysis of safety, J Pharmacol Pharmacother., 8, 92 Montastruc, 2019, Abatacept initiation in rheumatoid arthritis and the risk of serious infection: A population-based cohort study, Semin Arthritis Rheum., 48, 1053, 10.1016/j.semarthrit.2019.01.009 Grøn, 2019, Risk of serious infections in patients with rheumatoid arthritis treated in routine care with abatacept, rituximab and tocilizumab in Denmark and Sweden, Ann Rheum Dis., 78, 320, 10.1136/annrheumdis-2018-214326 Genovese, 2018, Longterm safety and efficacy of subcutaneous abatacept in patients with rheumatoid arthritis: 5-year results from a phase IIIb trial, J Rheumatol., 45, 1085, 10.3899/jrheum.170344 Distler, 2011, Is there a role for TNFα antagonists in the treatment of SSc? EUSTAR expert consensus development using the Delphi technique, Clin Exp Rheumatol., 29, S40 Murdaca, 2014, Potential use of TNF-α inhibitors in systemic sclerosis, Immunotherapy., 6, 283, 10.2217/imt.13.173 Omair, 2012, Long-term safety and effectiveness of tumour necrosis factor inhibitors in systemic sclerosis patients with inflammatory arthritis, Clin Exp Rheumatol., 30, S55 Denton, 2009, An open-label pilot study of infliximab therapy in diffuse cutaneous systemic sclerosis, Ann Rheum Dis., 68, 1433, 10.1136/ard.2008.096123 Lam, 2007, Efficacy and safety of etanercept in the treatment of scleroderma- associated joint disease, J Rheumatol., 34, 1636 Pereira, 2015, Safety of anti-TNF therapies in immune-mediated inflammatory diseases: focus on infections and malignancy, Drug Dev Res., 76, 419, 10.1002/ddr.21285 Walker, 2018, Haematopoietic stem cell transplantation in systemic sclerosis, RMD open., 4, e000533, 10.1136/rmdopen-2017-000533 Del Papa, 2017, Autologous hematopoietic stem cell transplantation has better outcomes than conventional therapies in patients with rapidly progressive systemic sclerosis, Bone MarrowTransplant., 52, 53 Szodoray, 2012, Immunological reconstitution after autologous stem cell transplantation in patients with refractory systemic autoimmune diseases, Scand J Rheumatol., 41, 110, 10.3109/03009742.2011.606788 Sullivan, 2018, Myeloablative autologous stem-cell transplantation for severe scleroderma, N Engl J Med., 378, 35, 10.1056/NEJMoa1703327 Van Laar, 2014, Autologous hematopoietic stem cell transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial, JAMA., 311, 2490, 10.1001/jama.2014.6368 Burt, 2011, Autologous non-myeloablative haemopoietic stem-cell transplantation compared with pulse cyclophosphamide once per month for systemic sclerosis (ASSIST): an open-label, randomised phase 2 trial, Lancet., 378, 498, 10.1016/S0140-6736(11)60982-3 Halloran, 2004, Immunosuppressive drugs for kidney transplantation, N Engl J Med., 351, 2715, 10.1056/NEJMra033540 Fishman, 2007, Infection in solid-organ transplant recipients, N Engl J Med., 357, 2601, 10.1056/NEJMra064928 Gavaldà, 2010, Risks and Epidemiology of Infections after Lung or Heart-Lung Transplantation, 114 Badesch, 2000, Continuous intravenous epoprostenol for pulmonary hypertension due to the scleroderma spectrum of disease. A randomized, controlled trial, Ann Intern Med., 132, 425, 10.7326/0003-4819-132-6-200003210-00002 2007, Bloodstream infections among patients treated with intravenous epoprostenol or intravenous treprostinil for pulmonary arterial hypertension--seven sites United States, 2003-2006, MMWR Morb Mortal Wkly Rep., 56, 170 Kitterman, 2012, Bloodstream infections in patients with pulmonary arterial hypertension treated with intravenous prostanoids: insights from the REVEAL REGISTRY®, Mayo Clin Proc., 87, 825, 10.1016/j.mayocp.2012.05.014 López-Medrano, 2012, High incidence of bloodstream infection due to gram-negative bacilli in patients with pulmonary hypertension receiving intravenous treprostinil, Arch Bronconeumol., 48, 443, 10.1016/j.arbres.2012.06.005 Ogielska, 2015, Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature, Int J Infect Dis., 37, 36, 10.1016/j.ijid.2015.06.007 Carvajal, 2017, [Clinical and demographic profile and risk factors for Clostridium difficile infection], Biomedica., 37, 53, 10.7705/biomedica.v37i1.2915 Eom, 2011, Use of acid-suppressive drugs and risk of pneumonia: a systematic review and meta-analysis, CMAJ., 183, 310, 10.1503/cmaj.092129 Johnstone, 2010, Meta-analysis: proton pump inhibitor use and the risk of community-acquired pneumonia, Aliment Pharmacol Ther., 31, 1165, 10.1111/j.1365-2036.2010.04284.x Lambert, 2015, Risk of community-acquired pneumonia with outpatient proton-pump inhibitor therapy: a systematic review and meta-analysis, PLoS One., 10, e0128004, 10.1371/journal.pone.0128004 Filion, 2014, Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with meta-analysis, Gut., 63, 552, 10.1136/gutjnl-2013-304738 Distler, 2019, Nintedanib for systemic sclerosis-associated interstitial lung disease, N Engl J Med., 380, 2518, 10.1056/NEJMoa1903076 Flaherty, 2019, Nintedanib in progressive fibrosing interstitial lung diseases, N Engl J Med., 381, 1718, 10.1056/NEJMoa1908681 Richeldi, 2014, Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis, N Engl J Med., 370, 2071, 10.1056/NEJMoa1402584 Ogura, 2015, Safety and pharmacokinetics of nintedanib and pirfenidone in idiopathic pulmonary fibrosis, Eur Respir J., 45, 1382, 10.1183/09031936.00198013 Kato, 2019, Gastrointestinal adverse effects of nintedanib and the associated risk factors in patients with idiopathic pulmonary fibrosis, Sci Rep., 9, 12062, 10.1038/s41598-019-48593-4 Lancaster, 2019, Safety and survival data in patients with idiopathic pulmonary fibrosis treated with nintedanib: pooled data from six clinical trials, BMJ open Respir Res., 6, e000397, 10.1136/bmjresp-2018-000397 King, 2014, A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis, N Engl J Med., 370, 2083, 10.1056/NEJMoa1402582 Fischer, 2019, Progressive fibrosing interstitial lung disease associated with systemic autoimmune diseases, Clin Rheumatol., 38, 2673, 10.1007/s10067-019-04720-0 Hachulla, 2016, Efficacy of sildenafil on ischaemic digital ulcer healing in systemic sclerosis: the placebo-controlled SEDUCE study, Ann Rheum Dis., 75, 1009, 10.1136/annrheumdis-2014-207001 Wei, 2016, Clinical adverse effects of endothelin receptor antagonists: insights from the meta-analysis of 4894 patients from 24 randomized double-blind placebo-controlled clinical trials, J Am Heart Assoc., 5, e003896, 10.1161/JAHA.116.003896 Thompson, 2001, Calcium-channel blockers for Raynaud's phenomenon in systemic sclerosis, Arthritis Rheum., 44, 1841, 10.1002/1529-0131(200108)44:8<1841::AID-ART322>3.0.CO;2-8 Roustit, 2013, Phosphodiesterase-5 inhibitors for the treatment of secondary Raynaud's phenomenon: systematic review and meta-analysis of randomised trials, Ann Rheum Dis., 72, 1696, 10.1136/annrheumdis-2012-202836 Rubin, 2015, Riociguat for the treatment of pulmonary arterial hypertension: a long-term extension study (PATENT-2), Eur Respir J., 45, 1303, 10.1183/09031936.00090614 Ghofrani, 2013, Riociguat for the treatment of pulmonary arterial hypertension, N Engl J Med., 369, 330, 10.1056/NEJMoa1209655 Drgona, 2018, Clin Microbiol Infect., 24, S83, 10.1016/j.cmi.2018.03.022 Pérez-Díaz, 2016, Infections with biological therapy: strategies for risk minimization in tropical and developing countries, J Infect Dev Ctries., 10, 1278, 10.3855/jidc.8222 Forero, 2016, Gestión de riesgo para la prescripción de terapias biológicas, Rev Colomb Reumatol., 23, 50 Aguilar-Company, 2018, ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Cell surface receptors and associated signaling pathways), Clin Microbiol Infect., 24, S41, 10.1016/j.cmi.2017.12.027 Redelman-Sidi, 2018, Clin Microbiol Infect., 24, S95, 10.1016/j.cmi.2018.01.030 Reinwald, 2018, ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Intracellular signaling pathways: tyrosine kinase and mTOR inhibitors), Clin Microbiol Infect., 24, S53, 10.1016/j.cmi.2018.02.009 Fernández-Ruiz, 2018, ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Introduction), Clin Microbiol Infect., 24, S2, 10.1016/j.cmi.2018.01.029 Van Assen, 2011, EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases, Ann Rheum Dis., 70, 414, 10.1136/ard.2010.137216 Kim, 2018, Advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older - United States, 2018, MMWR Morb Mortal Wkly Rep., 67, 158, 10.15585/mmwr.mm6705e3 Gómez Muñoz, 2016, Guías para la inmunización del adolescente y adulto en Colombia. Documento de actualización, 2016, Infectio., 20, 192, 10.1016/j.infect.2016.08.001 Forero, 2016, Risk management for prescribing biological therapies, Rev Colomb Reumatol., 23, 50 Roux, 2014, Update on pulmonary Pneumocystis jirovecii infection in non-HIV patients, Med Mal Infect., 44, 185, 10.1016/j.medmal.2014.01.007 Schmajuk, 2018, Pneumocystis jirovecii pneumonia (PJP) prophylaxis patterns among patients with rheumatic diseases receiving high-risk immunosuppressant drugs, Semin Arthritis Rheum., 48, 1087, 10.1016/j.semarthrit.2018.10.018 Yates, 2016, EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis, Ann Rheum Dis., 75, 1583, 10.1136/annrheumdis-2016-209133 Yates, 2017, Validation of the EULAR/ERA-EDTA recommendations for the management of ANCA-associated vasculitis by disease content experts, RMD open, 3, e000449, 10.1136/rmdopen-2017-000449 Park, 2018, Prophylactic effect of trimethoprim-sulfamethoxazole for pneumocystis pneumonia in patients with rheumatic diseases exposed to prolonged high-dose glucocorticoids, Ann Rheum Dis., 77, 644, 10.1136/annrheumdis-2017-211796 Kronbichler, 2018, Trimethoprim-sulfamethoxazole prophylaxis prevents severe/life-threatening infections following rituximab in antineutrophil cytoplasm antibody-associated vasculitis, Ann Rheum Dis., 77, 1440, 10.1136/annrheumdis-2017-212861 Clements, 2004, Regional differences in bronchoalveolar lavage and thoracic high-resolution computed tomography results in dyspneic patients with systemic sclerosis, Arthritis Rheum., 50, 1909, 10.1002/art.20265 Utsunomiya, 2017, Optimal regimens of sulfamethoxazole-trimethoprim for chemoprophylaxis of Pneumocystis pneumonia in patients with systemic rheumatic diseases: results from a non-blinded, randomized controlled trial, Arthritis Res Ther., 19, 7, 10.1186/s13075-016-1206-8 2018, Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV Ntatsaki, 2014, BSR and BHPR guideline for the management of adults with ANCA-associated vasculitis, Rheumatology., 53, 2306, 10.1093/rheumatology/ket445 Baulier, 2018, Guidelines for prophylaxis of Pneumocystis pneumonia cannot rely solely on CD4-cell count in autoimmune and inflammatory diseases, Clin Exp Rheumatol., 36, 490 Garnier, 2018, Zoster after cyclophosphamide for systemic lupus erythematosus or vasculitis: incidence, risk factors, and effect of antiviral prophylaxis, J Rheumatol., 45, 1541, 10.3899/jrheum.180310 Winthrop, 2009, Preventing and treating biologic-associated opportunistic infections, Nat Rev Rheumatol., 5, 405, 10.1038/nrrheum.2009.105 Winthrop, 2013, Bedfellows: mycobacteria and rheumatoid arthritis in the era of biologic therapy, Nat Rev Rheumatol., 9, 524, 10.1038/nrrheum.2013.82 2018, Latent TB Infection: Updated and consolidated guidelines for programmatic management Setti, 2009, Flu vaccination with a virosomal vaccine does not affect clinical course and immunological parameters in scleroderma patients, Vaccine., 27, 3367, 10.1016/j.vaccine.2009.01.078 Gelinck, 2008, The effect of anti-tumour necrosis factor treatment on the antibody response to influenza vaccination, Ann Rheum Dis., 67, 713, 10.1136/ard.2007.077552 Elkayam, 2010, The effect of infliximab and timing of vaccination on the humoral response to influenza vaccination in patients with rheumatoid arthritis and ankylosing spondylitis, Semin Arthritis Rheum., 39, 442, 10.1016/j.semarthrit.2008.12.002 Lanternier, 2008, Low influenza-vaccination rate among adults receiving immunosuppressive therapy for systemic inflammatory disease, Ann Rheum Dis., 67, 1047, 10.1136/ard.2007.081703 Sampaio-Barros, 2018, Pandemic non-adjuvanted influenza A H1N1 vaccine in a cohort of patients with systemic sclerosis, Rheumatology (Oxford)., 57, 1721, 10.1093/rheumatology/kex330 2012, Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP), MMWR Morb Mortal Wkly Rep., 61, 816 Hesselstrand, 2018, Immunogenicity and safety of pneumococcal vaccination in patients with systemic sclerosis, Rheumatology., 57, 625, 10.1093/rheumatology/kex471 Mercado, 2009, Antibody response to pneumococcal polysaccharide vaccine in systemic sclerosis, J Rheumatol., 36, 1549, 10.3899/jrheum.081227 Dooling, 2018, Recommendations of the advisory committee on immunization practices for use of herpes zoster vaccines, MMWR Morb Mortal Wkly Rep., 67, 103, 10.15585/mmwr.mm6703a5