High prevalence and mortality of Pneumocystis jirovecii pneumonia in anti-MDA5 antibody-positive dermatomyositis
Authors' conclusion
PJP has high prevalence and mortality in anti-MDA5+ DM.
Study context
- Population
- Anti-MDA5+ DM patients who underwent metagenomic next-generation sequencing (mNGS) or real-time PCR for Pneumocystis jirovecii pneumonia (PJP) detection
- Participants
- 91 patients
- Exposure
- PJP+ vs PJP− anti-MDA5+ DM patients; mNGS vs conventional methods for PJP detection
- PJP+n = 44
- Outcome
- PJP occurrence (detection rate) and its risk factors
Methodological detailslogistic regression, Cox proportional hazards regression, diagnostic performance of mNGS vs conventional methods
- Logistic regression
- Cox proportional hazards regression
- Diagnostic performance of mNGS vs conventional methods
Main finding
As reported in the abstract
PJP detection rate
PJP+
48.4%
44
- Fever and increased lactate dehydrogenase (LDH) independent risk factors for PJP occurrence; TMP/SMZ prophylaxis independent protective factor
- all P < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | PJP+ | mNGS |
|---|---|---|
| PJP occurring in the first 3 months of disease | 68.2% | — not stated in the abstract |
| Diagnostic performance for PJP | ||
| Sensitivity | — not stated in the abstract | 100.0% |
| Specificity | — not stated in the abstract | 90.0% |
| AUC | — not stated in the abstract | 0.95 |
— not stated in the abstract
- PJP occurring in the first 3 months of disease — Highest mortality rate in the first 3 months
- 20.5%
- Diagnostic performance for PJP: highest AUC (P < 0.001)
Predictors of mortality in anti-MDA5+ DM with PJP
- Older age and increased LDH predicted mortality
- all P < 0.05
Original publication
High prevalence and mortality of Pneumocystis jirovecii pneumonia in anti-MDA5 antibody-positive dermatomyositis. Rheumatology (Oxford). Published 3 February 2023. doi:10.
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