TY - JOUR T1 - Prevention of infections in patients with antineutrophil cytoplasm antibody-associated vasculitis: potential role of hydroxychloroquine JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - e19 LP - e19 DO - 10.1136/annrheumdis-2018-214508 VL - 79 IS - 2 AU - Pavel I Novikov AU - Nikolai M Bulanov AU - Anastasiia S Zykova AU - Sergey V Moiseev Y1 - 2020/02/01 UR - http://ard.bmj.com/content/79/2/e19.abstract N2 - In a recent observational study, Kronbichler et al recorded 95 severe/life-threatening infections in 49 of 192 patients (25.5%) with associated vasculitides (AAV) within approximately 2 years following rituximab initiation.1 Respiratory tract infections were the most common infectious complications. In patients with a positive culture, opportunistic pathogens were frequently seen, though Pneumocystis jirovecii was identified in only one case.Trimethoprim/sulfamethoxazole prophylaxis was administered in 73 of 192 patients (38.0%) and resulted in an impressive reduction in the risk of severe infectious complications by 70%. Approximately half of patients were treated with 480 mg or 960 mg on alternate days. The optimum prophylactic dose of trimethoprim/sulfamethoxazole in patients with non-HIV remains unknown. The current recommendations for the management of AAV encourage prophylaxis against P. jirovecii infection with trimethoprim/sulfamethoxazole 960 mg on alternate days or 480 mg daily in all patients being treated with cyclophosphamide, where not contraindicated.2 There is some evidence suggesting that a lower dose of trimethoprim/sulfamethoxazole may be equally effective and more safe than 480 mg daily. In a randomised controlled … ER -