Comparison of the Outcomes of Pneumocystis Jirovecii Pneumonia in Rheumatoid Arthritis Patients Treated with and Without Biologics

Background: To investigate the outcomes of Pneumocystis jirovecii pneumonia (PCP) between patients with rheumatoid arthritis (RA) treated with and without biologics before PCP onset. Patients and methods: We retrospectively included rheumatoid arthritis (RA) patients with PCP treated with and without biologics before PCP onset. The primary endpoints were 30-day and 180-day survival rates, and the secondary endpoint was severe PCP, including in -hospital death, intensive care unit admission, and requirement of respiratory support during hospitalization. Results: Eighty-two patients were enrolled in this study, including the Biologics group (n = 39) and Non-Biologics group (n = 43). There were no significantly differences in the 30-day and 180-day survival rates and severe PCP rate in the Biologics group and the Non-Biologics group before and after adjusting the patient characteristics. Kaplan-Meier survival curves for death showed no significantly differences between the Biologics and NonBiologics groups. Cox regression hazard analysis revealed that the average daily prednisolone dose within 90 days before PCP onset was weakly associated with mortality after PCP. Conclusions: Biologic use before PCP onset did not increase the severity and mortality of PCP compared to nonbiologics use in patients with RA.