{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:56:16Z","timestamp":1787237776899,"version":"build-2736575974"},"reference-count":15,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2012,11,28]],"date-time":"2012-11-28T00:00:00Z","timestamp":1354060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Coccidioidomycosis (valley fever) is an endemic fungal infection of the American Southwest, an area with a large population of patients with rheumatic diseases. There are currently no guidelines for management of patients who develop coccidioidomycosis while under treatment with biologic response modifiers (BRMs) or disease\u2010modifying antirheumatic drugs (DMARDs). We conducted a retrospective study of how both concurrent diseases were managed and the patient outcomes at 2 centers in Tucson, Arizona.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective chart review identified patients who developed coccidioidomycosis during treatment with DMARDs or BRMs. Patients were seen at least once in a university\u2010affiliated or Veterans Affairs outpatient rheumatology clinic in Tucson, Arizona, between 2007 and 2009.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010four patients were identified. Rheumatologic treatment included a BRM alone (n = 11), a DMARD alone (n = 8), or combination therapy (n = 25). Manifestations of coccidioidomycosis included pulmonary infection (n = 29), disseminated disease (n = 9), and asymptomatic positive coccidioidal serologies (n = 6). After the diagnosis of coccidioidomycosis, 26 patients had BRMs and DMARDs stopped, 8 patients had BRMs stopped but DMARD therapy continued, and 10 patients had no change in their immunosuppressive therapy. Forty\u2010one patients had antifungal therapy initiated for 1 month or longer. Followup data were available for 38 patients. BRM and\/or DMARD therapy was continued or resumed in 33 patients, only 16 of whom continued concurrent antifungal therapy. None of the patients have had subsequent dissemination or complications of coccidioidomycosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Re\u2010treating rheumatic disease patients with a BRM and\/or a DMARD after coccidioidomycosis appears to be safe in some patients. We propose a management strategy based on coccidioidomycosis disease activity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.21784","type":"journal-article","created":{"date-parts":[[2012,11,20]],"date-time":"2012-11-20T09:03:48Z","timestamp":1353402228000},"page":"1903-1909","source":"Crossref","is-referenced-by-count":50,"title":["Management of coccidioidomycosis in patients receiving biologic response modifiers or disease\u2010modifying antirheumatic drugs"],"prefix":"10.1002","volume":"64","author":[{"given":"Sara","family":"Taroumian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Knowles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Lisse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Yanes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil M.","family":"Ampel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Vaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John N.","family":"Galgiani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Hoover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,11,28]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph8041150"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1206.060028"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1563.081007"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0020002"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/323463"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066604267854"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011110"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1406.027"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20454"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.3.3.247"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1086\/496991"},{"key":"e_1_2_6_13_2","first-page":"79","article-title":"Fatal coccidioidomycosis in collagen vascular diseases","volume":"10","author":"Johnson WM","year":"1983","journal-title":"J Rheumatol"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198609000-00004"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1406.032"},{"key":"e_1_2_6_16_2","first-page":"1039","article-title":"In vitro whole\u2010blood analysis of cellular immunity in patients with active coccidioidomycosis by using the antigen preparation T27K","volume":"9","author":"Ampel NM","year":"2002","journal-title":"Clin Diagn Lab Immunol"}],"container-title":["Arthritis Care &amp; Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Facr.21784","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr.21784","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T16:47:27Z","timestamp":1759423647000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr.21784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,11,28]]},"references-count":15,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2012,12]]}},"alternative-id":["10.1002\/acr.21784"],"URL":"https:\/\/doi.org\/10.1002\/acr.21784","archive":["Portico"],"relation":{},"ISSN":["2151-464X","2151-4658"],"issn-type":[{"value":"2151-464X","type":"print"},{"value":"2151-4658","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,11,28]]}}}