{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:51:20Z","timestamp":1780581080601,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T00:00:00Z","timestamp":1698451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K23\u2010AR\u2010073334"],"award-info":[{"award-number":["K23\u2010AR\u2010073334"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R03\u2010AR\u2010078938"],"award-info":[{"award-number":["R03\u2010AR\u2010078938"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This manuscript assesses the incidence of <jats:italic>Pneumocystis jiroveci<\/jats:italic> pneumonia (PJP) among patients receiving contemporary treatment regimens for antineutrophil cytoplasmic antibody\u2013associated vasculitis (AAV) and adverse events associated with PJP prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Incident users of rituximab or cyclophosphamide for AAV were identified in the TriNetX electronic health records database from 2011 to 2022. The incidence rates (IRs) of PJP in the first 6 months of induction therapy with rituximab and\/or cyclophosphamide and during postinduction maintenance therapy with rituximab were calculated. Cox proportional hazard models were used to estimate hazard ratios (HRs) and confidence intervals (CIs) for the risk of adverse events commonly associated with PJP prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 1,461 AAV cases who received induction therapy with rituximab (69.7%), cyclophosphamide (18.9%), or both (11.4%). Prophylaxis prescribed within 30\u2009days of induction included trimethoprim\u2010sulfamethoxazole (30.7%), atovaquone (5.4%), dapsone (3.8%), and pentamidine (0.8%). During induction therapy, 10 cases of PJP were identified (IR 15.0 cases per 1,000 patient\u2010years); no deaths occurred. In adjusted analyses, those who received prophylaxis had a higher risk of leukopenia (HR 3.1; 95% CI 1.1\u20138.6), rash (HR 1.9; 95% CI 1.0\u20133.6), and nephropathy (HR 2.6; 95% CI 1.3\u20135.1) than those who did not.\u00a0During rituximab maintenance therapy (n\u00a0=\u00a0709), five cases of PJP were identified (IR 2.1 cases per 1,000 person\u2010years), one of whom died during the hospitalization associated with a PJP diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rates of PJP in patients with AAV were lower than previously observed, and few cases occurred during rituximab maintenance therapy. PJP prophylaxis was associated with adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.25222","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T21:39:48Z","timestamp":1693345188000},"page":"288-294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Incidence of <i>Pneumocystis Jiroveci<\/i> Pneumonia in Patients With <scp>ANCA\u2010Associated<\/scp> Vasculitis Initiating Therapy With Rituximab or Cyclophosphamide"],"prefix":"10.1002","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5737-295X","authenticated-orcid":false,"given":"Elizabeth","family":"Nettleton","sequence":"first","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3945-6828","authenticated-orcid":false,"given":"Sebastian E.","family":"Sattui","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center  Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Wallace","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Putman","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin  Milwaukee Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2014.03.003"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.19927"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(03)00038-0"},{"key":"e_1_2_6_5_1","article-title":"Prophylaxis for pneumocystis pneumonia (PCP) in non\u2010HIV immunocompromised patients","volume":"2014","author":"Stern A","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1996.00440020081010"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1992.00400150053009"},{"key":"e_1_2_6_8_1","unstructured":"Panel on the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. 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