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We deeply appreciate the comments by Suyama and Okada on our recent report regarding efficacy and safety of primary prophylaxis for pneumocystis pneumonia (PCP) using trimethoprim-sulfamethoxazole (TMP-SMX) in patients with rheumatic disease receiving prolonged, high-dose glucocorticoid treatment.1 2 They pointed out the possibility that patients with systemic lupus erythematosus (SLE) could have higher risk for adverse events related to TMP-SMX. They also indicated that discontinuation due …
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