Grant: Project Grant

Pneumocysitis jirovecii is a fungus which primarily causes pneumonia (PCP) in patients with weakened immune systems. It is an important cause of death due to opportunistic infection worldwide complicating conditions such as HIV, solid organ transplants, hematological and certain solid cancers, and inflammatory diseases. Despite being a deadly infection, the last randomized controlled trial for this disease was conducted in the 1990s and all therapeutic RCTs conducted have been in patients with HIV who were predominantly young men. In the 2020s, most patients with PCP are older and have medical comorbidities which complicate treatment because of adverse events and drug interactions. We therefore aim to establish an international PCP Platform trial which will enable us to recruit modern patients and answer multiple questions pertaining to the management of this lethal and neglected disease. A platform trial allows us to more efficiently answer several questions simultaneously, control for different decisions along the treatment pathway, and to generate additional randomized data to properly inform the design of future trials. Over the lifespan of this platform, we will be testing initial treatment choices, the use of new agents, which agents are best in patients will allergies or intolerances to the first line therapies, the duration of anti-inflammatory medications, and the prevention of recurrent infections.