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TMP/SMX was linked to fewer severe infections in IIM

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An illustration showing medical and healthcare icons including a protective shield with a white cross, medications and pills, a hospital building, lungs, a microscope, test tubes, a heart with inflammation, virus particles, and a petri dish on a blue background with scientific elements.
Research area:MedicineEpidemiologyPneumocystis jirovecii pneumonia detection and treatment

What the study found

Trimethoprim-sulfamethoxazole (TMP/SMX) use was associated with a lower risk of severe infections in patients with idiopathic inflammatory myopathy (IIM), especially respiratory tract infections. Older age was associated with a higher risk of severe infection.

Why the authors say this matters

The authors note that patients with IIM often receive glucocorticoids and other immunosuppressants, which increase the risk of opportunistic infections. They suggest TMP/SMX may help reduce severe infections beyond its usual role in preventing Pneumocystis jirovecii pneumonia (PJP), a type of opportunistic lung infection.

What the researchers tested

The researchers conducted a retrospective, single-center study of 89 patients diagnosed with IIM who underwent remission induction therapy. After excluding 2 patients who developed PJP, they analyzed 87 patients and used Cox regression analysis to look for risk factors for severe infection during follow-up.

What worked and what didn't

Sixteen patients developed severe infections other than PJP, and respiratory infections were the most common. Patients who received TMP/SMX had a significantly lower incidence of severe infections than those who did not, and respiratory tract infections were also significantly less common in TMP/SMX users. In multivariate analysis, TMP/SMX use was associated with reduced risk (HR 0.178; 95% CI, 0.056-0.57; p = 0.004), while older age increased risk (HR 1.063; 95% CI, 1.019-1.109; p = 0.005).

What to keep in mind

This was a retrospective, single-center study, so the available summary does not show whether the findings apply more broadly. The abstract does not describe additional limitations beyond the excluded PJP cases.

Key points

  • TMP/SMX use was associated with fewer severe infections in patients with idiopathic inflammatory myopathy.
  • Respiratory tract infections were the most common severe infections reported.
  • Older age was associated with a higher risk of severe infection.
  • The study excluded 2 patients who developed Pneumocystis jirovecii pneumonia.
  • The study analyzed 87 patients after exclusions.

Disclosure

Research title:
TMP/SMX was linked to fewer severe infections in IIM
Authors:
Masahiro Kogami, Yoshiyuki Abe, Taiki Ando, Ayako Makiyama, Ken Yamaji, Naoto Tamura
Institutions:
Artistic Realization Technologies, Artistic Realization Technologies, Artistic Realization Technologies, Artistic Realization Technologies, Artistic Realization Technologies, CITIC Group (China), CITIC Group (China), CITIC Group (China), CITIC Group (China), CITIC Group (China), Juntendo University, Juntendo University, Juntendo University, Juntendo University, Juntendo University, Juntendo University
Publication date:
2026-02-23
DOI:
10.1097/rhu.0000000000002325
OpenAlex record:
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AI provenance: This post was generated by gpt-5.4-mini (OpenAI). The original authors did not write or review this post.