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We read with interest the article ‘Trimethoprim–sulfamethoxazole prophylaxis prevents severe/life-threatening infections following rituximab in antineutrophil cytoplasm antibody-associated vasculitis’ by Kronbichler et al.1 Severe infections continue to be a significant cause of morbidity and mortality in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), and we commend the authors for pursuing this study. However, we have several concerns regarding their methodologies.
First, more than 90% of patients with AAV analysed were prevalent cases. This may limit the generalisability of their findings to incident cases in whom there has been no prior treatment with cyclophosphamide or other immunosuppressive agents. As the authors note, there was an average delay of 4 years …
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