Cited 23 times in
Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients Receiving Rituximab
DC Field | Value | Language |
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dc.contributor.author | 양재석 | - |
dc.date.accessioned | 2022-12-22T02:00:34Z | - |
dc.date.available | 2022-12-22T02:00:34Z | - |
dc.date.issued | 2022-05 | - |
dc.identifier.issn | 0012-3692 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/191416 | - |
dc.description.abstract | Background: Although previous studies suggested that rituximab increases the risk of Pneumocystis jirovecii pneumonia (PJP), it is uncertain whether its primary prophylaxis for PJP is justified. Research question: Does the benefit of primary prophylaxis for PJP in patients receiving rituximab treatment outweigh the potential risk of the prophylaxis? Study design and methods: 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. Results: 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). Interpretation: TMP-SMX prophylaxis significantly reduces PJP incidence with a tolerable safety profile in patients receiving rituximab treatment. | - |
dc.description.statementOfResponsibility | open | - |
dc.language | English | - |
dc.publisher | American College of Chest Physicians | - |
dc.relation.isPartOf | CHEST | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Pneumonia, Pneumocystis* / drug therapy | - |
dc.subject.MESH | Pneumonia, Pneumocystis* / epidemiology | - |
dc.subject.MESH | Pneumonia, Pneumocystis* / prevention & control | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Rheumatic Diseases* / complications | - |
dc.subject.MESH | Rituximab / adverse effects | - |
dc.subject.MESH | Trimethoprim, Sulfamethoxazole Drug Combination / adverse effects | - |
dc.title | Primary Prophylaxis for Pneumocystis jirovecii Pneumonia in Patients Receiving Rituximab | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학교실) | - |
dc.contributor.googleauthor | Jun Won Park | - |
dc.contributor.googleauthor | Jeffrey R Curtis | - |
dc.contributor.googleauthor | Kang Il Jun | - |
dc.contributor.googleauthor | Tae Min Kim | - |
dc.contributor.googleauthor | Dae Seog Heo | - |
dc.contributor.googleauthor | Jongwon Ha | - |
dc.contributor.googleauthor | Kyung-Suk Suh | - |
dc.contributor.googleauthor | Kwang-Woong Lee | - |
dc.contributor.googleauthor | Hajeong Lee | - |
dc.contributor.googleauthor | Jaeseok Yang | - |
dc.contributor.googleauthor | Min Jung Kim | - |
dc.contributor.googleauthor | Yunhee Choi | - |
dc.contributor.googleauthor | Eun Bong Lee | - |
dc.identifier.doi | 10.1016/j.chest.2021.11.007 | - |
dc.contributor.localId | A06130 | - |
dc.relation.journalcode | J00520 | - |
dc.identifier.eissn | 1931-3543 | - |
dc.identifier.pmid | 34788668 | - |
dc.subject.keyword | Pneumocystis jirovecii | - |
dc.subject.keyword | prophylaxis | - |
dc.subject.keyword | rituximab | - |
dc.subject.keyword | trimethoprim-sulfamethoxazole | - |
dc.contributor.alternativeName | Yang, Jaeseok | - |
dc.contributor.affiliatedAuthor | 양재석 | - |
dc.citation.volume | 161 | - |
dc.citation.number | 5 | - |
dc.citation.startPage | 1201 | - |
dc.citation.endPage | 1210 | - |
dc.identifier.bibliographicCitation | CHEST, Vol.161(5) : 1201-1210, 2022-05 | - |
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