Observational studyArthritis & rheumatology (Hoboken, N.J.)2025
Clinical Factors Associated With Pneumocystis Pneumonia Despite Its Primary Prophylaxis: When to Stop Prophylaxis?
Observational study in Arthritis & rheumatology (Hoboken, N.J.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Temporal trends and clinical outcomes of pediatric invasive fungal diseases: a ten-year retrospective study from a tertiary-care center in Thailand.BMC infectious diseases · 2026Article
- Platelet-to-neutrophil ratio and in-hospital mortality in pneumonia patients receiving glucocorticoid therapy: a multicenter retrospective cohort study.Frontiers in medicine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectiveAlthough previous studies show that primary prophylaxis against Pneumocystis jirovecii pneumonia (PJP) is effective in patients with rheumatic diseases receiving immunosuppressive treatment, there is limited evidence regarding the optimal timing for prophylaxis withdrawal. This study aimed to identify the risk factors for PJP despite prophylaxis and provide evidence for an optimal prophylaxis schedule.
methodsThis case-control study included 1,294 prophylactic episodes in 1,148 patients with rheumatic disease who received immunosuppressants and prophylactic trimethoprim-sulfamethoxazole (TMP-SMX). The primary outcome was a one-year incidence of PJP. A Cox proportional hazards model with least absolute shrinkage and selection operator was used to evaluate clinical factors associated with outcomes.
resultsDuring 1,174 person-years of observation, 10 cases of PJP were identified, with an incidence rate of 0.85 per 100 person-years. The mean ± SD duration of TMP-SMX prophylaxis was 181.9 ± 128.7 days. Except in one case, PJP occurred after discontinuation of TMP-SMX, with a median (interquartile range [IQR]) interval of 117.0 (86.0-161.0) days. The dose of glucocorticoids at the time of TMP-SMX discontinuation was significantly higher in the PJP group relative to the control group (median [IQR]: 22 [20-40] vs 10 [5-15] mg). Discontinuing TMP-SMX while on a glucocorticoid dose >12.5 mg/day of prednisone equivalent significantly increased the risk of PJP (adjusted hazard ratio: 13.84; 95% confidence interval, 1.71-111.80). There were 63 cases of adverse events during the observation period, and 10 (15.9%) were attributed to TMP-SMX with probable causality.
conclusionTapering glucocorticoids with 12.5 mg/day of prednisone equivalent could be a reasonable timepoint to initiate the withdrawal of PJP prophylaxis in patients with rheumatic diseases.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.