<i>Pneumocystis Jirovecii</i> Pneumonia in Japanese Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor Inhibitors: A Pooled Analysis of 3 Agents
Bibliographic record
Abstract
To the Editor: Pneumocystis jirovecii pneumonia (PCP) is an infectious fungal disease caused by P. jirovecii , which has attracted the attention of physicians treating patients with human immunodeficiency virus infection1, as well as those with connective tissue diseases, malignancies, and organ transplantation2. In patients with rheumatoid arthritis (RA), PCP used to be an uncommon infectious disease, but the number of case reports of PCP in patients with RA has increased since the introduction of low-dose methotrexate as an anchor drug for RA in the 1980s3. Moreover, with the introduction of anti-tumor necrosis factor (TNF) therapy, a further increase of incidence of PCP in patients with RA has been noticed, especially in Japan where strict postmarketing surveillance (PMS) programs have been conducted for patients with RA treated with TNF inhibitors4,5,6. The numbers of patients with RA with PCP in these PMS programs who were treated with infliximab (IFX), etanercept (ETN), or adalimumab (ADA) were 22 (0.4%) out of 50004, 25 (0.18%) out of 13,8945, and 25 (0.33%) out of 7469 patients6, respectively. Notably, these incidence rates of PCP in Japan are higher than the corresponding figure (0.01%) reported from the United States. Therefore, we previously analyzed the clinical characteristics and risk factors for PCP in patients with RA in Japan treated with these 3 TNF inhibitors7,8,9,10 … Address correspondence to Dr. M. Harigai, Department of Pharmacovigilance, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. E-mail: mharigai.mpha{at}tmd.ac.jp
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.007 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".