{"id":21907,"date":"2022-09-01T04:28:00","date_gmt":"2022-08-31T20:28:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21907"},"modified":"2022-09-01T04:43:37","modified_gmt":"2022-08-31T20:43:37","slug":"chest%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%88%a9%e5%a6%a5%e6%98%94%e5%8d%95%e6%8a%97%e6%b2%bb%e7%96%97%e6%82%a3%e8%80%85%e8%82%ba%e5%ad%a2%e5%ad%90%e8%99%ab%e8%82%ba%e7%82%8e%e7%9a%84","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21907","title":{"rendered":"[Chest\u53d1\u8868\u8bba\u6587]\uff1a\u5229\u59a5\u6614\u5355\u6297\u6cbb\u7597\u60a3\u8005\u80ba\u5b62\u5b50\u866b\u80ba\u708e\u7684\u4e00\u7ea7\u9884\u9632"},"content":{"rendered":"\n

CHEST INFECTIONS: ORIGINAL RESEARCH| VOLUME 161, ISSUE 5<\/a>, P1201-1210, MAY 01, 2022<\/p>\n\n\n\n

Primary Prophylaxis for\u00a0Pneumocystis jirovecii<\/em> Pneumonia in Patients Receiving Rituximab<\/h1>\n\n\n\n

Jun Won Park, Jeffrey R. Curtis, Kang Il Jun,\u00a0et al<\/h3>\n\n\n\n

Chest 2022; 161: 1201-1210<\/h3>\n\n\n\n

Background<\/h3>\n\n\n\n

Although previous studies suggested that rituximab increases the risk of Pneumocystis jirovecii<\/em> pneumonia (PJP), it is uncertain whether its primary prophylaxis for PJP is justified.<\/p>\n\n\n\n

Research Question<\/h3>\n\n\n\n

Does the benefit of primary prophylaxis for PJP in patients receiving rituximab treatment outweigh the potential risk of the prophylaxis?<\/p>\n\n\n\n

Study Design and Methods<\/h3>\n\n\n\n

This retrospective study included 3,524 patients (hematologic diseases, 2,500; rheumatic diseases, 559; pre\/post-solid organ transplantation, 465) first exposed to rituximab between 2002 and 2018 in a tertiary referral center in South Korea. Patients were classified into a control group (n = 2,523) and a prophylaxis group (n = 1,001) according to the administration of prophylactic trimethoprim-sulfamethoxazole (TMP-SMX) during the first 28 days after the start of rituximab (intention-to-treat analysis). In addition, exposure to TMP-SMX was examined as a time-varying variable (time-varying analysis). The primary outcome was the prophylactic effect of TMP-SMX on the 1-year incidence of PJP. Inverse probability of treatment weights was applied to minimize the baseline imbalance. The secondary outcome included the incidence of adverse drug reactions (ADRs) related to TMP-SMX.<\/p>\n\n\n\n

Results<\/h3>\n\n\n\n

Over 2,759.9 person-years, 92 PJP infections occurred, with a mortality rate of 27.2%. The prophylaxis group showed a significantly lower incidence of PJP (adjusted subdistribution hazard ratio, 0.20 [95% CI, 0.10-0.42]) than the control group. This result was consistent with the results of time-varying analysis, in which only one PJP infection occurred during TMP-SMX administration (adjusted subdistribution hazard ratio, 0.01 [0.003-0.16]). The incidence of ADRs related to TMP-SMX was 18.1 (14.6-22.2)\/100 person-years, and most were of mild to moderate severity. On the basis of 10 severe ADRs, the number needed to harm was 101 (61.9-261.1), whereas the number needed to prevent one PJP infection was 32 (24.8-39.4).<\/p>\n\n\n\n

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Interpretation<\/h3>\n\n\n\n

TMP-SMX prophylaxis significantly reduces PJP incidence with a tolerable safety profile in patients receiving rituximab treatment.<\/p>\n","protected":false},"excerpt":{"rendered":"

CHEST INFECTIONS: ORIGINAL RESEARCH| VOLUME 161, I […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21907"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21907"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21907\/revisions"}],"predecessor-version":[{"id":22559,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21907\/revisions\/22559"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21907"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21907"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21907"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}