{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:56:11Z","timestamp":1793382971494,"version":"4.5.0"},"reference-count":56,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T00:00:00Z","timestamp":1570838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T00:00:00Z","timestamp":1570838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004844","name":"National Cheng Kung University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004844","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To estimate and compare the burdens of opportunistic infections and herpes zoster in real-world practice among patients with various systemic rheumatic diseases.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This 13-year cohort study used national health insurance data to compare the incidence rates (IRs) of nine opportunistic infections among patients with five rheumatic diseases. The analyses were stratified according to follow-up duration using Poisson regression, and Cox models were used to compare the risk of first opportunistic infection.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During 2000\u20132013, we identified 76,966 patients who had polymyositis\/dermatomyositis (PM\/DM, 2270 cases), systemic lupus erythematosus (SLE, 15,961 cases), systemic sclerosis (SSc, 2071 cases), rheumatoid arthritis (RA, 38,355 cases), or primary Sj\u00f6gren\u2019s syndrome (pSS, 18,309 cases). The IR of opportunistic infections was highest for PM\/DM cases (61.3\/1000 person-years, 95% confidence interval [CI] 56.6\u201366.2), followed by SLE cases (43.1\/1000 person-years, 95% CI 41.7\u201344.5), SSc cases (31.6\/1000 person-years, 95% CI 28.3\u201335.1), RA cases (25.0\/1000 person-years, 95% CI 24.4\u201325.7), and pSS cases (24.1\/1000 person-years, 95% CI 23.1\u201325.2). Multivariable Cox analysis revealed that, relative to SLE, PM\/DM was associated with a significantly higher risk of opportunistic infections (hazard ratio 1.18, 95% CI 1.08\u20131.29). The risk of opportunistic infections was highest during the first year after the diagnosis of all five rheumatic diseases.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The risk of opportunistic infection was highest for PM\/DM, followed by SLE, SSc, RA, and pSS. Careful observation and preventive therapy for opportunistic infections may be warranted in selected PM\/DM patients, especially during the first year after the diagnosis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13075-019-1997-5","type":"journal-article","created":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T06:50:32Z","timestamp":1570863032000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Comparing the burdens of opportunistic infections among patients with systemic rheumatic diseases: a nationally representative cohort study"],"prefix":"10.1186","volume":"21","author":[{"given":"Chung-Yuan","family":"Hsu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Hua","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiun-Ling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsai-Ching","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2273-7877","authenticated-orcid":false,"given":"Chun-Yu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,12]]},"reference":[{"key":"1997_CR1","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1002\/art.39070","volume":"67","author":"CH Feldman","year":"2015","unstructured":"Feldman CH, Hiraki LT, Winkelmayer WC, et al. Serious infections among adult Medicaid beneficiaries with systemic lupus erythematosus and lupus nephritis. Arthritis Rheumatol. 2015;67:1577\u201385.","journal-title":"Arthritis Rheumatol"},{"key":"1997_CR2","doi-asserted-by":"publisher","first-page":"e0154441","DOI":"10.1371\/journal.pone.0154441","volume":"11","author":"JM Peng","year":"2016","unstructured":"Peng JM, Du B, Wang Q, et al. Dermatomyositis and polymyositis in the intensive care unit: a single-center retrospective cohort study of 102 patients. PLoS One. 2016;11:e0154441.","journal-title":"PLoS One"},{"key":"1997_CR3","first-page":"2230","volume":"28","author":"I Marie","year":"2001","unstructured":"Marie I, Hatron PY, Dominique S, et al. Polymyositis and dermatomyositis: short term and long term outcome, and predictive factors of prognosis. J Rheumatol. 2001;28:2230\u20137.","journal-title":"J Rheumatol"},{"key":"1997_CR4","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/01.md.0000109755.65914.5e","volume":"83","author":"K Dank\u00f3","year":"2004","unstructured":"Dank\u00f3 K, Ponyi A, Constantin T, et al. Long-term survival of patients with idiopathic inflammatory myopathies according to clinical features: a longitudinal study of 162 cases. Medicine. 2004;83:35\u201342.","journal-title":"Medicine"},{"key":"1997_CR5","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1080\/08916930500285352","volume":"38","author":"G Zandman-Goddard","year":"2005","unstructured":"Zandman-Goddard G, Shoenfeld Y. Infections and SLE. Autoimmunity. 2005;38:473\u201385.","journal-title":"Autoimmunity"},{"key":"1997_CR6","doi-asserted-by":"publisher","first-page":"1286","DOI":"10.1177\/0961203313493032","volume":"22","author":"A Danza","year":"2013","unstructured":"Danza A, Ruiz-Irastorza G. Infection risk in systemic lupus erythematosus patients: susceptibility factors and preventive strategies. Lupus. 2013;22:1286\u201394.","journal-title":"Lupus"},{"key":"1997_CR7","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1016\/S0889-857X(05)70016-8","volume":"24","author":"M Petri","year":"1998","unstructured":"Petri M. Infection in systemic lupus erythematosus. Rheum Dis Clin North Am. 1998;24:423\u201356.","journal-title":"Rheum Dis Clin North Am"},{"key":"1997_CR8","doi-asserted-by":"publisher","first-page":"2107","DOI":"10.1136\/annrheumdis-2015-207841","volume":"74","author":"KL Winthrop","year":"2015","unstructured":"Winthrop KL, Novosad SA, Baddley JW, et al. Opportunistic infections and biologic therapies in immune-mediated inflammatory diseases: consensus recommendations for infection reporting during clinical trials and postmarketing surveillance. Ann Rheum Dis. 2015;74:2107\u201316.","journal-title":"Ann Rheum Dis"},{"key":"1997_CR9","first-page":"1559","volume":"19","author":"M Petri","year":"1992","unstructured":"Petri M, Genovese M. Incidence of and risk factors for hospitalizations in systemic lupus erythematosus: a prospective study of the Hopkins lupus cohort. J Rheumatol. 1992;19:1559\u201365.","journal-title":"J Rheumatol"},{"key":"1997_CR10","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1177\/0961203318792352","volume":"27","author":"SC Yang","year":"2018","unstructured":"Yang SC, Lai YY, Huang MC, Tsai CS, Wang JL. Corticosteroid dose and the risk of opportunistic infection in a national systemic lupus erythematosus cohort. Lupus. 2018;27:1819\u201327.","journal-title":"Lupus"},{"key":"1997_CR11","doi-asserted-by":"publisher","first-page":"e1138","DOI":"10.1097\/MD.0000000000001138","volume":"94","author":"SY Tsai","year":"2015","unstructured":"Tsai SY, Lin CL, Wong YC, et al. Increased risk of herpes zoster following dermatomyositis and polymyositis: a nationwide population-based cohort study. Medicine. 2015;94:e1138.","journal-title":"Medicine"},{"key":"1997_CR12","doi-asserted-by":"publisher","first-page":"16303","DOI":"10.1038\/srep16303","volume":"5","author":"PH Wu","year":"2015","unstructured":"Wu PH, Lin YT, Yang YH, Lin YC, Lin YC. The increased risk of active tuberculosis disease in patients with dermatomyositis - a nationwide retrospective cohort study. Sci Rep. 2015;5:16303.","journal-title":"Sci Rep"},{"key":"1997_CR13","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1001\/jama.2018.0246","volume":"319","author":"SL Chang","year":"2018","unstructured":"Chang SL, Huang YL, Lee MC, et al. Association of varicose veins with incident venous thromboembolism and peripheral artery disease. JAMA. 2018;319:807\u201317.","journal-title":"JAMA"},{"key":"1997_CR14","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1002\/pds.2087","volume":"20","author":"CL Cheng","year":"2011","unstructured":"Cheng CL, Kao YH, Lin SJ, Lee CH, Lai ML. Validation of the national health insurance research database with ischemic stroke cases in Taiwan. Pharmacoepidemiol Drug Saf. 2011;20:236\u201342.","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"1997_CR15","first-page":"157","volume":"104","author":"CC Lin","year":"2005","unstructured":"Lin CC, Lai MS, Syu CY, Chang SC, Tseng FY. Accuracy of diabetes diagnosis in health insurance claims data in Taiwan. J Formos Med Assoc. 2005;104:157\u201363.","journal-title":"J Formos Med Assoc"},{"key":"1997_CR16","doi-asserted-by":"publisher","first-page":"1725","DOI":"10.1002\/art.1780400928","volume":"40","author":"MC Hochberg","year":"1997","unstructured":"Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40:1725.","journal-title":"Arthritis Rheum"},{"key":"1997_CR17","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1002\/art.1780310302","volume":"31","author":"FC Arnett","year":"1988","unstructured":"Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315\u201324.","journal-title":"Arthritis Rheum"},{"key":"1997_CR18","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1002\/art.27584","volume":"62","author":"D Aletaha","year":"2010","unstructured":"Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology\/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62:2569\u201381.","journal-title":"Arthritis Rheum"},{"key":"1997_CR19","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1002\/art.1780360309","volume":"36","author":"C Vitali","year":"1993","unstructured":"Vitali C, Bombardieri S, Moutsopoulos HM, et al. Preliminary criteria for the classification of Sj\u00f6gren\u2019s syndrome. Results of a prospective concerted action supported by the European Community. Arthritis Rheum. 1993;36:340\u20137.","journal-title":"Arthritis Rheum"},{"key":"1997_CR20","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1136\/ard.61.6.554","volume":"61","author":"C Vitali","year":"2002","unstructured":"Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sj\u00f6gren\u2019s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Ann Rheum Dis. 2002;61:554\u20138.","journal-title":"Ann Rheum Dis"},{"key":"1997_CR21","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1002\/art.1780230510","volume":"23","author":"Preliminary criteria for the classification of systemic sclerosis (scleroderma)","year":"1980","unstructured":"Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum. 1980;23:581\u201390.","journal-title":"Arthritis Rheum"},{"key":"1997_CR22","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1056\/NEJM197502132920706","volume":"292","author":"A Bohan","year":"1975","unstructured":"Bohan A, Peter JB. Polymyositis and dermatomyositis (first of two parts). N Engl J Med. 1975;292:344\u20137.","journal-title":"N Engl J Med"},{"key":"1997_CR23","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1056\/NEJM197502202920807","volume":"292","author":"A Bohan","year":"1975","unstructured":"Bohan A, Peter JB. Polymyositis and dermatomyositis (second of two parts). N Engl J Med. 1975;292:403\u20137.","journal-title":"N Engl J Med"},{"key":"1997_CR24","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.jclinepi.2006.07.011","volume":"60","author":"S Schneeweiss","year":"2007","unstructured":"Schneeweiss S, Robicsek A, Scranton R, Zuckerman D, Solomon DH. Veteran's affairs hospital discharge databases coded serious bacterial infections accurately. J Clin Epidemiol. 2007;60:397\u2013409.","journal-title":"J Clin Epidemiol"},{"key":"1997_CR25","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1002\/pds.1625","volume":"17","author":"CG Grijalva","year":"2008","unstructured":"Grijalva CG, Chung CP, Stein CM, et al. Computerized definitions showed high positive predictive values for identifying hospitalizations for congestive heart failure and selected infections in Medicaid enrollees with rheumatoid arthritis. Pharmacoepidemiol Drug Saf. 2008;17:890\u20135.","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"1997_CR26","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","volume":"94","author":"JP Fine","year":"1999","unstructured":"Fine JP, Gray RJ. A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc. 1999;94:496\u2013509.","journal-title":"J Am Stat Assoc"},{"key":"1997_CR27","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1097\/00005792-198409000-00001","volume":"63","author":"SC Ross","year":"1984","unstructured":"Ross SC, Densen P. Complement deficiency states and infection: epidemiology, pathogenesis and consequences of neisserial and other infections in an immune deficiency. Medicine. 1984;63:243\u201373.","journal-title":"Medicine"},{"key":"1997_CR28","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1002\/art.1780290606","volume":"29","author":"JG Wilson","year":"1986","unstructured":"Wilson JG, Ratnoff WD, Schur PH, Fearon DT. Decreased expression of the C3b\/C4b receptor (CR1) and the C3d receptor (CR2) on B lymphocytes and of CR1 on neutrophils of patients with systemic lupus erythematosus. Arthritis Rheum. 1986;29:739\u201347.","journal-title":"Arthritis Rheum"},{"key":"1997_CR29","first-page":"627","volume":"12","author":"SC Hsieh","year":"1994","unstructured":"Hsieh SC, Tsai CY, Sun KH, et al. Decreased spontaneous and lipopolysaccharide stimulated production of interleukin 8 by polymorphonuclear neutrophils of patients with active systemic lupus erythematosus. Clin Exp Rheumatol. 1994;12:627\u201333.","journal-title":"Clin Exp Rheumatol"},{"key":"1997_CR30","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/BF01533366","volume":"14","author":"BL Bermas","year":"1994","unstructured":"Bermas BL, Petri M, Goldman D, et al. T helper cell dysfunction in systemic lupus erythematosus (SLE): relation to disease activity. J Clin Immunol. 1994;14:169\u201377.","journal-title":"J Clin Immunol"},{"key":"1997_CR31","doi-asserted-by":"publisher","first-page":"1475","DOI":"10.1002\/art.1780390906","volume":"39","author":"BD Pryor","year":"1996","unstructured":"Pryor BD, Bologna SG, Kahl LE. Risk factors for serious infection during treatment with cyclophosphamide and high-dose corticosteroids for systemic lupus erythematosus. Arthritis Rheum. 1996;39:1475\u201382.","journal-title":"Arthritis Rheum"},{"key":"1997_CR32","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1136\/ard.2003.006122","volume":"63","author":"M Fathi","year":"2004","unstructured":"Fathi M, Dastmalchi M, Rasmussen E, Lundberg IE, Tornling G. Interstitial lung disease, a common manifestation of newly diagnosed polymyositis and dermatomyositis. Ann Rheum Dis. 2004;63:297\u2013301.","journal-title":"Ann Rheum Dis"},{"key":"1997_CR33","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1093\/rheumatology\/keh723","volume":"44","author":"EH Kang","year":"2005","unstructured":"Kang EH, Lee EB, Shin KC, et al. Interstitial lung disease in patients with polymyositis, dermatomyositis and amyopathic dermatomyositis. Rheumatology. 2005;44:1282\u20136.","journal-title":"Rheumatology"},{"key":"1997_CR34","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1183\/09031936.00054810","volume":"37","author":"NL Smith","year":"2011","unstructured":"Smith NL, Denning DW. Underlying conditions in chronic pulmonary aspergillosis including simple aspergilloma. Eur Respir J. 2011;37:865\u201372.","journal-title":"Eur Respir J"},{"key":"1997_CR35","doi-asserted-by":"publisher","first-page":"896","DOI":"10.3346\/jkms.2012.27.8.896","volume":"27","author":"SW Park","year":"2012","unstructured":"Park SW, Song JW, Shim TS, et al. Mycobacterial pulmonary infections in patients with idiopathic pulmonary fibrosis. J Korean Med Sci. 2012;27:896\u2013900.","journal-title":"J Korean Med Sci"},{"key":"1997_CR36","first-page":"1719","volume":"32","author":"H Kameda","year":"2005","unstructured":"Kameda H, Nagasawa H, Ogawa H, et al. Combination therapy with corticosteroids, cyclosporin A, and intravenous pulse cyclophosphamide for acute\/subacute interstitial pneumonia in patients with dermatomyositis. J Rheumatol. 2005;32:1719\u201326.","journal-title":"J Rheumatol"},{"key":"1997_CR37","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1007\/s10067-005-0147-4","volume":"26","author":"E Miyazaki","year":"2007","unstructured":"Miyazaki E, Ando M, Muramatsu T, et al. Early assessment of rapidly progressive interstitial pneumonia associated with amyopathic dermatomyositis. Clin Rheumatol. 2007;26:436\u20139.","journal-title":"Clin Rheumatol"},{"key":"1997_CR38","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1002\/acr.21664","volume":"64","author":"BH Hahn","year":"2012","unstructured":"Hahn BH, McMahon MA, Wilkinson A, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res. 2012;64:797\u2013808.","journal-title":"Arthritis Care Res"},{"key":"1997_CR39","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1056\/NEJM199202063260602","volume":"326","author":"B Sigurgeirsson","year":"1992","unstructured":"Sigurgeirsson B, Lindel\u00f6f B, Edhag O, Allander E. Risk of cancer in patients with dermatomyositis or polymyositis. A population-based study. N Engl J Med. 1992;326:363\u20137.","journal-title":"N Engl J Med"},{"key":"1997_CR40","doi-asserted-by":"publisher","first-page":"e0154746","DOI":"10.1371\/journal.pone.0154746","volume":"11","author":"N Mugii","year":"2016","unstructured":"Mugii N, Hasegawa M, Matsushita T, et al. Oropharyngeal dysphagia in dermatomyositis: associations with clinical and laboratory features including autoantibodies. PLoS One. 2016;11:e0154746.","journal-title":"PLoS One"},{"key":"1997_CR41","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1016\/j.berh.2017.12.003","volume":"31","author":"Q Wu","year":"2017","unstructured":"Wu Q, Wedderburn LR, McCann LJ. Juvenile dermatomyositis: Latest advances. Best Pract Res Clin Rheumatol. 2017;31:535\u201357.","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"1997_CR42","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1002\/art.21083","volume":"53","author":"I Marie","year":"2005","unstructured":"Marie I, Hachulla E, Ch\u00e9rin P, et al. Opportunistic infections in polymyositis and dermatomyositis. Arthritis Rheum. 2005;53:155\u201365.","journal-title":"Arthritis Rheum"},{"key":"1997_CR43","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1001\/archdermatol.2009.152","volume":"145","author":"L Fardet","year":"2009","unstructured":"Fardet L, Rybojad M, Gain M, et al. Incidence, risk factors, and severity of herpesvirus infections in a cohort of 121 patients with primary dermatomyositis and dermatomyositis associated with a malignant neoplasm. Arch Dermatol. 2009;145:889\u201393.","journal-title":"Arch Dermatol"},{"key":"1997_CR44","doi-asserted-by":"publisher","first-page":"3570","DOI":"10.1002\/art.21378","volume":"52","author":"AV Ramanan","year":"2005","unstructured":"Ramanan AV, Campbell-Webster N, Ota S, et al. The effectiveness of treating juvenile dermatomyositis with methotrexate and aggressively tapered corticosteroids. Arthritis Rheum. 2005;52:3570\u20138.","journal-title":"Arthritis Rheum"},{"key":"1997_CR45","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1093\/rheumatology\/keq407","volume":"50","author":"H Schmeling","year":"2011","unstructured":"Schmeling H, Stephens S, Goia C, et al. Nailfold capillary density is importantly associated over time with muscle and skin disease activity in juvenile dermatomyositis. Rheumatology. 2011;50:885\u201393.","journal-title":"Rheumatology"},{"key":"1997_CR46","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/j.nmd.2015.04.013","volume":"25","author":"NE Johnson","year":"2015","unstructured":"Johnson NE, Arnold WD, Hebert D, et al. Disease course and therapeutic approach in dermatomyositis: a four-center retrospective study of 100 patients. Neuromuscul Disord. 2015;25:625\u201331.","journal-title":"Neuromuscul Disord"},{"key":"1997_CR47","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1097\/00005792-200303000-00002","volume":"82","author":"M Viguier","year":"2003","unstructured":"Viguier M, Fou\u00e9r\u00e9 S, de la Salmoni\u00e8re P, et al. Peripheral blood lymphocyte subset counts in patients with dermatomyositis: clinical correlations and changes following therapy. Medicine. 2003;82:82\u20136.","journal-title":"Medicine"},{"key":"1997_CR48","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1186\/s13075-018-1725-6","volume":"20","author":"JL Davignon","year":"2018","unstructured":"Davignon JL, Rauwel B, Degbo\u00e9 Y, et al. Modulation of T-cell responses by anti-tumor necrosis factor treatments in rheumatoid arthritis: a review. Arthritis Res Ther. 2018;20:229.","journal-title":"Arthritis Res Ther"},{"key":"1997_CR49","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1186\/s13075-018-1667-z","volume":"20","author":"TA Stamm","year":"2018","unstructured":"Stamm TA, Machold KP, Aletaha D, et al. Induction of sustained remission in early inflammatory arthritis with the combination of infliximab plus methotrexate: the DINORA trial. Arthritis Res Ther. 2018;20:174.","journal-title":"Arthritis Res Ther"},{"key":"1997_CR50","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1136\/annrheumdis-2018-214367","volume":"78","author":"A Pawar","year":"2019","unstructured":"Pawar A, Desai RJ, Solomon DH, et al. Risk of serious infections in tocilizumab versus other biologic drugs in patients with rheumatoid arthritis: a multidatabase cohort study. Ann Rheum Dis. 2019;78:456\u201364.","journal-title":"Ann Rheum Dis"},{"key":"1997_CR51","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1016\/S0140-6736(14)61704-9","volume":"386","author":"JA Singh","year":"2015","unstructured":"Singh JA, Cameron C, Noorbaloochi S, et al. Risk of serious infection in biological treatment of patients with rheumatoid arthritis: a systematic review and meta-analysis. Lancet. 2015;386:258\u201365.","journal-title":"Lancet"},{"key":"1997_CR52","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1093\/rheumatology\/keq242","volume":"50","author":"JB Galloway","year":"2011","unstructured":"Galloway JB, Hyrich KL, Mercer LK, et al. Anti-TNF therapy is associated with an increased risk of serious infections in patients with rheumatoid arthritis especially in the first 6 months of treatment: updated results from the British Society for Rheumatology Biologics Register with special emphasis on risks in the elderly. Rheumatology (Oxford). 2011;50:124\u201331.","journal-title":"Rheumatology (Oxford)"},{"key":"1997_CR53","first-page":"387","volume":"35","author":"AL Smitten","year":"2008","unstructured":"Smitten AL, Choi HK, Hochberg MC, et al. The risk of hospitalized infection in patients with rheumatoid arthritis. J Rheumatol. 2008;35:387\u201393.","journal-title":"J Rheumatol"},{"key":"1997_CR54","volume-title":"Taiwan Tuberculosis Control Report","author":"Taiwan Centers for Disease Control","year":"2013","unstructured":"Taiwan Centers for Disease Control. Taiwan Tuberculosis Control Report. 2013. \n                    https:\/\/www.cdc.gov.tw\/uploads\/files\/201407\/103228a0-fadd-47b0-b056-8dedda9fce1d.pdf"},{"key":"1997_CR55","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/1741-7015-11-97","volume":"11","author":"SV Ramagopalan","year":"2013","unstructured":"Ramagopalan SV, Goldacre R, Skingsley A, Conlon C, Goldacre MJ. Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies. BMC Med. 2013;11:97.","journal-title":"BMC Med"},{"key":"1997_CR56","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1136\/ard.2007.070177","volume":"66","author":"A Airio","year":"2007","unstructured":"Airio A, Kauppi M, Kautiainen H, Hakala M, Kinnula V. High association of mycobacterial infections with polymyositis in a non-endemic country for tuberculosis. Ann Rheum Dis. 2007;66:1404\u20135.","journal-title":"Ann Rheum Dis"}],"container-title":["Arthritis Research &amp; Therapy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-019-1997-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13075-019-1997-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-019-1997-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T23:11:41Z","timestamp":1602371501000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthritis-research.biomedcentral.com\/articles\/10.1186\/s13075-019-1997-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,12]]},"references-count":56,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["1997"],"URL":"https:\/\/doi.org\/10.1186\/s13075-019-1997-5","relation":{},"ISSN":["1478-6362"],"issn-type":[{"value":"1478-6362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,12]]},"assertion":[{"value":"5 April 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The Institutional review board of National Cheng Kung University Hospital approved this study (B-EX-108-012). Informed consent was not required because the datasets were devoid of personally identifiable information.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"211"}}