Do Rituximab-Treated Patients with Rheumatic Diseases Need Prophylaxis Against Pneumocystis jirovecii Pneumonia?

Receipt of rituximab therapy is a risk factor for Pneumocystis jirovecii pneumonia (PJP), yet the magnitude of that risk remains unclear. To ascertain which rituximab-treated patients with rheumatic diseases would benefit from PJP prophylaxis, researchers conducted a retrospective cohort study of risk factors and PJP incidence. Among 818 patients receiving rituximab, 419 also received prophylaxis with trimethoprim/sulfamethoxazole (TMP/SMX) and 399 received no such prophylaxis (control). Patients in the TMP/SMX group were more likely than controls to receive concomitant corticosteroids (63.5% vs. 24.1%).

Incidence of PJP was 2.2 per 100 person-years in patients not receiving TMP/SMX versus 1.2 per 100 person years in treated patients, althou…