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Manifestasi Kelainan Paru pada Lupus Eritematosus Sistemik: Tinjauan Pustaka Apriance, Yessi; Kurniati, Roza; Fauzar
Cermin Dunia Kedokteran Vol 52 No 2 (2025): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i2.1277

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a very dynamic course and various clinical manifestations. With respiratory tract involvement in 50%-70% of patients, pulmonary disorders are one of the causes of the high morbidity and mortality in SLE patients. The high mortality in SLE patients with pulmonary disorders contribute to patients' survival with a hazard ratio of 3.13. This article discusses the manifestations of pulmonary disorders in SLE patients.

A Meta-Analysis of Electric Cigarette Use and Lung Health Implications Florensia, Rika; Fauzar; Roza Kurniati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 10 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i10.1099

Background: The global rise in electric cigarette (e-cigarette) use has prompted urgent investigation into their health effects. This meta-analysis aims to consolidate evidence regarding the impact of e-cigarette use on lung health. Methods: A systematic search of PubMed, Embase, and Cochrane Library databases was conducted, identifying studies published between 2018 and 2024 that assessed lung function, respiratory symptoms, and lung disease incidence in e-cigarette users. Studies meeting inclusion criteria were subjected to quality assessment and data extraction. Random-effects models were used for pooled analysis, and heterogeneity was assessed. Results: Twenty-three studies, encompassing 12,456 participants, were included. E-cigarette use was associated with a small but significant decrease in forced expiratory volume in 1 second (FEV1) (standardized mean difference [SMD] -0.18, 95% CI -0.26 to -0.10, p<0.001). Increased odds of wheezing (odds ratio [OR] 1.38, 95% CI 1.15 to 1.65, p=0.001) and chronic cough (OR 1.25, 95% CI 1.08 to 1.44, p=0.003) were also observed in e-cigarette users. No significant association was found with chronic obstructive pulmonary disease (COPD) incidence. Conclusion: E-cigarette use appears detrimental to lung function and associated with respiratory symptoms. Further long-term research is imperative to establish definitive conclusions on the risk of COPD and other lung diseases.

Outcomes of Surgical Resection versus Medical Management in Chronic Pulmonary Aspergillosis: A Systematic Review and Meta-Analysis of Comparative Cohorts Avino Mulana Fikri; Fauzar; Roza Kurniati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1540

Background: Chronic pulmonary aspergillosis (CPA) is a progressive and debilitating fungal infection that complicates structural lung diseases, particularly in patients with a history of treated tuberculosis. The therapeutic strategy remains a subject of intense debate, polarized between surgical resection, which offers a potential definitive cure but carries significant operative risks, and long-term azole therapy, which is suppressive but prone to drug resistance and high relapse rates. This study aimed to systematically evaluate survival outcomes and recurrence risks between these two modalities, specifically addressing the clinical heterogeneity between simple aspergilloma (SA) and chronic cavitary pulmonary aspergillosis (CCPA). Methods: We conducted a systematic review and meta-analysis of six pivotal retrospective cohort studies published between 2013 and 2022, representing the modern era of thoracic surgery. Databases including PubMed, Scopus, and Embase were searched for comparative studies reporting overall survival (OS) and recurrence rates. Data were pooled using a random-effects model to account for clinical heterogeneity. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS), with specific adjustments for allocation bias and confounding factors. Results: The meta-analysis integrated data from 268 patients. Surgical resection was associated with a significant reduction in all-cause mortality compared to medical therapy (Pooled Hazard Ratio [HR] 0.12; 95% CI 0.04–0.35). In stratified analysis, recurrence rates were 2.7% for simple aspergilloma versus 10.3% for CCPA in surgical arms, contrasting sharply with relapse rates of 36–50% in medical arms upon drug cessation. An analysis of adjuvant antifungal therapy in a subset of patients showed no statistical benefit in completely resected simple aspergilloma. Postoperative complications occurred in 24.5% of surgical cases, primarily consisting of prolonged air leaks. Conclusion: Surgical resection offers superior recurrence-free survival in selected candidates with localized disease compared to medical therapy. While effectively curative for simple aspergilloma, surgery in CCPA acts as a cytoreductive measure with a persisting recurrence risk, necessitating a multimodal approach. Medical therapy remains the mainstay for patients with bilateral disease or poor pulmonary reserve, but requires indefinite duration to prevent relapse.

Comparative Efficacy, Safety, and Patient Preference of One-Month (1HP) versus Three-Month (3HP) Rifapentine-Based Regimens for Latent Tuberculosis: A Network Meta-Analysis of HIV, Silicosis, and General Risk Populations Muhammad Ridwan; Roza Kurniati; Fauzar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1544

Background: The programmatic management of latent tuberculosis infection (LTBI) is undergoing a paradigm shift from long-course isoniazid monotherapy to short-course rifamycin-based regimens. While the 3-month weekly rifapentine/isoniazid (3HP) regimen is well-established, the ultra-short 1-month daily rifapentine/isoniazid (1HP) regimen offers a potential advancement in adherence. However, concerns regarding systemic hypersensitivity reactions, hepatotoxicity mechanisms, and efficacy in non-HIV populations like silicosis remain. Methods: We conducted a systematic review and network meta-analysis (NMA) utilizing a random-effects frequentist model. We executed a comprehensive search of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials to identify randomized controlled trials comparing rifapentine-based regimens. We analyzed data comprising over 10,000 participants to evaluate the efficacy (prevention of active TB), safety (hepatotoxicity and hypersensitivity), and completion rates of 1HP, 3HP, 4-month rifampin (4R), and 9-month isoniazid (9H). We specifically integrated novel data on silicosis patients and patient preference metrics. Results: The network analysis demonstrated that 1HP was non-inferior to 9H in preventing active tuberculosis (Incidence Rate Difference: -0.02 per 100 person-years). 1HP achieved the highest treatment completion rate (97%), significantly superior to 3HP (82%) and 9H (69%). Safety analysis revealed a distinct divergence: 3HP was associated with a higher incidence of systemic flu-like drug reactions (3.5%) compared to 9H (0.4%), whereas 1HP demonstrated a safety profile that minimized both the hepatotoxicity of isoniazid and the hypersensitivity of intermittent rifapentine. In silicosis patients, modified 1-month regimens proved safe. However, preference analysis indicated that 81% of patients preferred the weekly dosing of 3HP over the daily burden of 1HP. Conclusion: 1HP represents the most effective strategy for maximizing treatment completion without compromising bactericidal activity. The daily dosing of 1HP appears to induce immune tolerance, mitigating the hypersensitivity reactions observed in weekly 3HP dosing. While 3HP remains a viable option for those preferring less frequent dosing, 1HP is the superior clinical recommendation for rapid sterilization of latent reservoirs.

Outcomes of Surgical Resection versus Medical Management in Chronic Pulmonary Aspergillosis: A Systematic Review and Meta-Analysis of Comparative Cohorts Avino Mulana Fikri; Fauzar; Roza Kurniati
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1540

Background: Chronic pulmonary aspergillosis (CPA) is a progressive and debilitating fungal infection that complicates structural lung diseases, particularly in patients with a history of treated tuberculosis. The therapeutic strategy remains a subject of intense debate, polarized between surgical resection, which offers a potential definitive cure but carries significant operative risks, and long-term azole therapy, which is suppressive but prone to drug resistance and high relapse rates. This study aimed to systematically evaluate survival outcomes and recurrence risks between these two modalities, specifically addressing the clinical heterogeneity between simple aspergilloma (SA) and chronic cavitary pulmonary aspergillosis (CCPA). Methods: We conducted a systematic review and meta-analysis of six pivotal retrospective cohort studies published between 2013 and 2022, representing the modern era of thoracic surgery. Databases including PubMed, Scopus, and Embase were searched for comparative studies reporting overall survival (OS) and recurrence rates. Data were pooled using a random-effects model to account for clinical heterogeneity. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS), with specific adjustments for allocation bias and confounding factors. Results: The meta-analysis integrated data from 268 patients. Surgical resection was associated with a significant reduction in all-cause mortality compared to medical therapy (Pooled Hazard Ratio [HR] 0.12; 95% CI 0.04–0.35). In stratified analysis, recurrence rates were 2.7% for simple aspergilloma versus 10.3% for CCPA in surgical arms, contrasting sharply with relapse rates of 36–50% in medical arms upon drug cessation. An analysis of adjuvant antifungal therapy in a subset of patients showed no statistical benefit in completely resected simple aspergilloma. Postoperative complications occurred in 24.5% of surgical cases, primarily consisting of prolonged air leaks. Conclusion: Surgical resection offers superior recurrence-free survival in selected candidates with localized disease compared to medical therapy. While effectively curative for simple aspergilloma, surgery in CCPA acts as a cytoreductive measure with a persisting recurrence risk, necessitating a multimodal approach. Medical therapy remains the mainstay for patients with bilateral disease or poor pulmonary reserve, but requires indefinite duration to prevent relapse.

Comparative Efficacy, Safety, and Patient Preference of One-Month (1HP) versus Three-Month (3HP) Rifapentine-Based Regimens for Latent Tuberculosis: A Network Meta-Analysis of HIV, Silicosis, and General Risk Populations Muhammad Ridwan; Roza Kurniati; Fauzar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1544

Background: The programmatic management of latent tuberculosis infection (LTBI) is undergoing a paradigm shift from long-course isoniazid monotherapy to short-course rifamycin-based regimens. While the 3-month weekly rifapentine/isoniazid (3HP) regimen is well-established, the ultra-short 1-month daily rifapentine/isoniazid (1HP) regimen offers a potential advancement in adherence. However, concerns regarding systemic hypersensitivity reactions, hepatotoxicity mechanisms, and efficacy in non-HIV populations like silicosis remain. Methods: We conducted a systematic review and network meta-analysis (NMA) utilizing a random-effects frequentist model. We executed a comprehensive search of MEDLINE, Embase, and Cochrane Central Register of Controlled Trials to identify randomized controlled trials comparing rifapentine-based regimens. We analyzed data comprising over 10,000 participants to evaluate the efficacy (prevention of active TB), safety (hepatotoxicity and hypersensitivity), and completion rates of 1HP, 3HP, 4-month rifampin (4R), and 9-month isoniazid (9H). We specifically integrated novel data on silicosis patients and patient preference metrics. Results: The network analysis demonstrated that 1HP was non-inferior to 9H in preventing active tuberculosis (Incidence Rate Difference: -0.02 per 100 person-years). 1HP achieved the highest treatment completion rate (97%), significantly superior to 3HP (82%) and 9H (69%). Safety analysis revealed a distinct divergence: 3HP was associated with a higher incidence of systemic flu-like drug reactions (3.5%) compared to 9H (0.4%), whereas 1HP demonstrated a safety profile that minimized both the hepatotoxicity of isoniazid and the hypersensitivity of intermittent rifapentine. In silicosis patients, modified 1-month regimens proved safe. However, preference analysis indicated that 81% of patients preferred the weekly dosing of 3HP over the daily burden of 1HP. Conclusion: 1HP represents the most effective strategy for maximizing treatment completion without compromising bactericidal activity. The daily dosing of 1HP appears to induce immune tolerance, mitigating the hypersensitivity reactions observed in weekly 3HP dosing. While 3HP remains a viable option for those preferring less frequent dosing, 1HP is the superior clinical recommendation for rapid sterilization of latent reservoirs.

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