Incidence of pneumocystosis among patients exposed to immunosuppressants is very low, according to a recent study. Therefore, prophylaxis for patients receiving combination immunosuppressant and corticosteroid therapy, the group at highest risk, may be warranted. Researchers conducted a retrospective cohort analysis identifying incident pneumocystosis cases among adults without HIV/AIDS or cancer exposed to immunosuppressant and/or corticosteroid therapy. They found:
- 406 new cases were identified among patients prescribed an immunosuppressant, corticosteroid, or both.
- Overall incidence of pneumocystosis was 0.012% (406/3,366,086).
- Incidence was highest in those exposed to immunosuppressant and corticosteroid medications (0.199%), followed by groups exposed to immunosuppressant alone (0.012%), corticosteroid alone (0.008%), and neither medication (0.001%).
- Greatest risk differences were noted between groups exposed to immunosuppressant and corticosteroid compared with neither (0.198%) and with immunosuppressant alone (0.188%).
- Greatest relative risks were noted among those receiving immunosuppressant and corticosteroid compared with those exposed to neither or to immunosuppressant alone.
Rekhtman S, Strunk A, Garg A. Incidence of pneumocystosis among patients exposed to immunosuppression. [Published online ahead of print January 9, 2019]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.12.052.