{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:40:11Z","timestamp":1791819611236,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000251803"],"award-info":[{"award-number":["RS\u20102023\u201000251803"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective of this study was to investigate the effect of prophylactic trimethoprim\u2010sulfamethoxazole (TMP\u2010SMX) on the incidence of serious infections in patients with antineutrophil cytoplasmic antibody\u2013associated vasculitis (AAV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This multicenter cohort study was designed to emulate a target trial that studied 296 patients with AAV who were treated with rituximab (RTX) or cyclophosphamide (CYC) as induction therapy. Patients were grouped based on the administration of TMP\u2010SMX within 14 days following induction therapy (n = 240 and 56 patients in prophylaxis and control groups, respectively) (intention\u2010to\u2010treat) and also as a time\u2010dependent exposure (time\u2010varying). Inverse probability weighting was applied to minimize the baseline imbalance between the two groups. The primary outcome was one\u2010year incidence of serious infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the 252.1 person\u2010years of observation, 77 cases of serious infections were recorded in 65 patients with a fatality rate of 18.5%. Most serious infections (n = 66, 85.7%) occurred within the first 180 days of observation. The prophylaxis group showed a significantly lower incidence of serious infections than the control group (hazard ratio [HR] 0.48 [95% confidence interval (CI) 0.32\u20130.72]). However, this beneficial effect of TMP\u2010SMX was only significant during the first 180 days (HR 0.41 [95% CI 0.22\u20130.76]) and not thereafter (HR 3.67 [95% CI 0.46\u201329.43]) (interaction <jats:italic>P<\/jats:italic> = 0.044). This result was also consistent with the time\u2010varying analysis result. Based on one case of severe adverse drug reaction related to TMP\u2010SMX, the number needed to harm was 127.4, whereas the number needed to treat to prevent one serious infection was 8.0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prophylactic TMP\u2010SMX significantly reduced the risk of serious infections in patients with AAV, particularly during the first six months of induction therapy with RTX or CYC.<\/jats:p><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art43185-toc-0001-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1002\/art.43185","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T22:59:26Z","timestamp":1744671566000},"page":"1407-1415","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Time\u2010Dependent Effect of Prophylactic Trimethoprim\u2010Sulfamethoxazole on the Incidence of Serious Infections in Antineutrophil Cytoplasmic Antibody\u2013Associated Vasculitis: A Target Trial Emulation Study"],"prefix":"10.1002","volume":"77","author":[{"given":"Yun Kyu","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8907-8976","authenticated-orcid":false,"given":"Jeffrey R.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology &amp; Rheumatology University of Alabama at Birmingham  Birmingham Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Rim","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam\u2010si Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jina","family":"Yeo","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine Gachon University Gil Medical Center  Incheon Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine Seoul Metropolitan Government Seoul National University, Boramae Medical Center  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7615-8611","authenticated-orcid":false,"given":"Yun Jong","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, and Division of Rheumatology, Department of Internal Medicine Seoul National University Bundang Hospital  Seongnam\u2010si Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0703-1208","authenticated-orcid":false,"given":"Eun Bong","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences Graduate School of Convergence Science and Technology, Seoul National University  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8624-2582","authenticated-orcid":false,"given":"Jun Won","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine Seoul National University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfac320"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203927"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209133"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/eci.12410"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.160909"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.137778"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.109389"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211796"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42541"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-212861"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/p34lkr"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223764"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2407586"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221794"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221795"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221796"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.101279"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ad.2019.05.009"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02799-9"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.6607"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176345693"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-222543"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyu222"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa699"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223401"},{"key":"e_1_2_6_28_1","volume-title":"Trimethoprim 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