Risk Factors of Tanaka et al for Pneumocystis jirovecii Infection in a Patient with Rheumatoid Arthritis Treated with a Tumor Necrosis Factor alpha Inhibitor (TNFI)

Patient selection: rheumatoid arthritis treated with a TNF-alpha inhibitors (infliximab, etanercept, adalimumab)

Outcome: pneumonia with Pneumocystis jirovecii

Risk factors:

(1) older age

(2) diabetes mellitus

(3) comorbid pulmonary disease (COPD, other)

(4) daily dose of prednisolone >= 5 mg (or equivalent agent)

where:

• The age range for pneumocystis patients was 65.5 +/- 9.5 years vs 55.2 +/- 12.7 years for controls. An age > 60 years will be used in the implementation.

Interpretation:

• The risk of pneumocystis pneumonia increased with the number of risk factors present.