Management of Rheumatoid Arthritis in Patients with Coccidioidomycosis

Principal Investigator: Dominick Sudano, MD 
Funding: UA Arthritis Center

In the U.S. Southwest, Coccidioidomycosis (cocci) or Valley fever is an endemic fungal infection. It typically presents as a self-limited pulmonary illness.  Patients with autoimmune diseases who are on disease-modifying anti-rheumatic drugs (DMARDs) or biologic response modifiers (BRMs or biologics) are at higher risk of more severe infection or infection disseminated outside the thoracic cavity. Currently, there are no management guidelines for cocci in such patients.

This project seeks to examine the clinical course and management of patients on DMARDs or BRMs who are identified as having a positive serologic test for Coccidioidomycosis on routine surveillance laboratory testing or who developed symptoms or findings of active infection.

All patients with rheumatic diseases are eligible for enrollment, including patients with rheumatoid arthritis, spondyloarthritis such as ankylosing spondylitis and psoriatic arthritis, lupus and inflammatory myopathy.

The overall goal is to enroll a prospective cohort of patients in order to develop screening guidelines and a management algorithm for patients on disease-modifying anti-rheumatic drugs (DMARDs) or biologic response modifiers (BRMs).

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