Treatments of patients with autoimmune disease at the time of diagnosis of the invasive fungal disease (IFD)
| Treatments | Pneumocystis pneumonia (227) | Fungemia (167) | Invasive aspergillosis (84) | Other IFD (58) | Multiple IFD (13) | Total (549) | P value* |
| Glucocorticoids | 178 (78.4) | 89 (53.3) | 49 (58.3) | 41 (70.7) | 8 (62) | 365 (66.5) | <0.001 |
| High dose† | 125 (55.1) | 63 (37.7) | 36 (42.9) | 25 (43.1) | 5 (38) | 254 (46.3) | 0.002 |
| Median daily dose (IQR)‡ | 22.5 (10–45) | 25 (10–40) | 35 (10–60) | 15 (10–37.5) | 20 (5–60) | 20 (10–45) | 0.77 |
| Immunosuppressant§ | 135 (59.5) | 67 (40.1) | 50 (59.5) | 27 (46.6) | 6 (46) | 285 (51.9) | <0.001 |
| Methotrexate | 82 (36.1) | 15 (9.0) | 6 (7.1) | 10 (17.2) | 1 (8) | 114 (20.8) | – |
| Azathioprine | 16 (7.0) | 11 (6.6) | 5 (6.0) | 4 (6.9) | 1 (8) | 37 (6.7) | – |
| Cyclophosphamide | 14 (6.2) | 2 (1.2) | 8 (9.5) | 3 (5.2) | 0 | 27 (4.9) | – |
| Mycophenolate | 5 (2.2) | 5 (3.0) | 8 (9.5) | 3 (5.2) | 1 (8) | 22 (4.0) | – |
| Other | 18 (7.9) | 34 (20.4) | 24 (28.6) | 9 (15.5) | 3 (23) | 88 (16.0) | – |
| TNF-α blocker¶ | 14 (6.2) | 11 (6.6) | 11 (13.1) | 5 (8.6) | 1 (8) | 42 (7.7) | 0.10 |
| Infliximab | 4 (1.8) | 4 (2.4) | 3 (3.6) | 3 (5.2) | 1 (8) | 15 (2.7) | – |
| Adalimumab | 3 (1.3) | 4 (2.4) | 4 (4.8) | 1 (1.7) | 0 | 12 (2.2) | – |
| Other | 2 (0.9) | 2 (1.2) | 1 (1.2) | 1 (1.7) | 0 | 6 (1.1) | – |
| Other biologic | 33 (14.5) | 20 (12.0) | 16 (19.1) | 4 (6.9) | 2 (15) | 75 (13.7) | 0.32 |
| Rituximab | 26 (11.5) | 9 (5.4) | 9 (10.7) | 1 (1.7) | 1 (8) | 46 (8.4) | – |
| Chemotherapy** | 1 (0.4) | 9 (5.4) | 12 (14.3) | 1 (1.7) | 2 (15) | 25 (4.6) | <0.001 |
| None of the above | 18 (7.9) | 41 (24.6) | 7 (8.3) | 8 (13.8) | 1 (8) | 75 (13.7) | <0.001 |
Results are presented as n (%).
*P value: test applied to the three main IFD categories (Pneumocystis pneumonia, fungemia, invasive aspergillosis).
†High-dose: over 0.3 mg/kg/day prednisone-equivalent dose for at least month.
‡Prednisone-equivalent dose among those on GCs, missing data for the detailed dose: 88/365 (24.1%).
§35 patients had a combination of at least two immunosuppressants (including 1 patient with invasive aspergillosis, on azathioprine and mycophenolate, and 2 patients with another IFD, on azathioprine combined respectively with methotrexate and cyclophosphamide; they are included in the totals for each immunosuppressive agent).
¶Missing detail on type of TNF-α blocker in 9 patients.
**For patients with a solid cancer or a haematological malignancy in addition to the AID.
AID, autoimmune diseases; GC, glucocorticoids; TNF-α, Tumor necrosis factor alpha.