Pneumocystis pneumonia in patients with rheumatic diseases receiving prolonged, non-high-dose steroids—clinical implication of primary prophylaxis using trimethoprim–sulfamethoxazole

Table 2 Clinical factors affecting 1-year PCP incidence

	Univariable analysis		Multivariable analysis^a
	HR (95% CI)	p value	Adjusted HR (95% CI)	p value
Old age (≥ 70 years old)	4.4 (0.5–39.6)	0.183	b
Male sex	1.5 (0.2–13.7)	0.702	b
Disease duration (years)	0.9 (0.7–1.2)	0.482	b
Initial steroid dose, mg (based on prednisone)	1.1 (0.9–1.4)	0.377	b
Concomitant steroid-pulse treatment	75.0 (8.4–671.4)	< 0.001	68.4 (5.3–876.0)	0.001
Concomitant cyclophosphamide treatment	12.2 (2.0–72.8)	0.006	1.5 (0.2–10.5)	0.707
Concomitant azathioprine	0.9 (0.1–7.8)	0.904	b
Concomitant MMF	1.2 (0.1–10.6)	0.881	b
Concomitant MTX	3.5 (0.6–21.1)	0.167	b
Concomitant TNFi	4.6 (0.03–40.8)	0.395	b
High cumulative steroid dose^c (≥ 900 mg)	4.9 (0.8–29.0)	0.084	1.7 (0.1–4.8)	0.610
Interstitial lung disease	2.8 (0.3–24.7)	0.363
Baseline lymphopenia^d	10.7 (1.8–63.8)	0.010	6.3 (1.01–39.1)	0.049

CI confidence interval, HR hazard ratio, MMF mycophenolate mofetil, MTX methotrexate, PCP pneumocystis pneumonia, TNFi tumor necrosis factor inhibitor
^aModel included clinical factors that showed significant association (p < 0.1) in the univariable analysis, and was adjusted for clustering
^bNot included in the multivariable model as a covariate
^cCumulative steroid (prednisone) dose during the previous 6 months
^dDefined as < 800 lymphocytes per microliter

ISSN: 1478-6362