Pneumocystis jirovecii pneumonia in anti-MDA5-positive dermatomyositis: characterisation, risk factors and prognosis
Authors' conclusion
PJP significantly increases early mortality of anti-MDA5+DM patients.
Study context
- Population
- Anti-MDA5+ DM patients who underwent metagenomic next-generation sequencing of bronchoalveolar lavage fluid or lung tissue, single centre, January 2019 to February 2023
- Participants
- 107 patients
- Exposure
- Pneumocystis jirovecii pneumonia (PJP)+ vs PJP− anti-MDA5+ DM patients
- PJP+n = 47
- Outcome
- Risk and prognostic factors of PJP
Methodological detailssingle-centre, univariate and multivariate logistic regression
- Single-centre
- Univariate and multivariate logistic regression
Main finding
As reported in the abstract
Independent risk factors for PJP (multivariate logistic regression)
- Older age: independent risk factor for PJP
- p<0.05
- High cumulative GC dosage within 3 months before PJP diagnosis: independent risk factor for PJP
- p<0.05
- Prophylactic-dose TMP/SMZ: significantly reduced risk of PJP
- p<0.05
Observational data: associations, not effects.
Further findings
- 30-day mortality in PJP+ · 30 days
- 55.3%
Factors associated with unfavourable prognosis in PJP+
- Short disease duration and immunosuppressive therapy exposure, severe hypoxia, extensive radiological ILD, moderate to severe ARDS, mechanical ventilation associated with unfavourable prognosis
- P < 0.05
- GC therapy more frequently given in survivors
- P < 0.05
- All p<0.05
Original publication
Pneumocystis jirovecii pneumonia in anti-MDA5-positive dermatomyositis: characterisation, risk factors and prognosis. Clin Exp Rheumatol. Published 10 February 2025. doi:10.
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