Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel and University Hospital Basel, Basel, Switzerland.
Respirology. 2012 Jul;17(5):861-8. doi: 10.1111/j.1440-1843.2012.02187.x.
Radiotherapy and an increasing number of substances are implicated in the pathogenesis of interstitial lung disease (ILD). While the frequency of published data on more common ILD entities such as the idiopathic interstitial pneumonias has increased in recent years, less attention has been given to relatively rarely occurring forms such as drug-/radiation-induced ILD.
Data from the UK-based General Practice Research Database (GPRD) was used to estimate the incidence of drug-/radiation-induced ILD over a 12-year period (1997-2008). Crude incidence rates were stratified by gender, age group and calendar period, and rate ratios were adjusted using Poisson regression. All-cause mortality was modelled using Cox regression, and characteristics at diagnosis were compared with a random sample of matched, non-ILD controls using conditional logistic regression.
A total of 128 patients with an incident diagnosis of drug-/radiation-induced ILD were identified, and the overall incidence density during the study period was 4.1 (95% confidence interval 3.4-4.9) per million person-years. Incidence rates increased during the time period 1997-2005 and decreased thereafter. The adjusted all-cause mortality was >4 times higher in cases compared with controls.
This UK population-based study characterizes patients diagnosed with drug-/radiation-induced ILD and quantifies incidence and all-cause mortality during 1997-2008. No statistically significant time trend in incidence was found, despite having observed numeric increases in incidence rates during the study window. Future research using the GPRD and other data sources is required to better understand the disposition of patients diagnosed with drug-/radiation-induced ILD and to investigate potential trends incidence and mortality over time.
放疗和越来越多的物质与间质性肺病（ILD）的发病机制有关。近年来，发表的关于特发性间质性肺炎等更常见ILD 实体的数据频率有所增加，而相对罕见的形式，如药物/放射性ILD 则受到较少关注。
使用英国基于全科医生研究数据库（GPRD）的数据，在 12 年期间（1997-2008 年）估计药物/放射性ILD 的发病率。按性别、年龄组和日历期对粗发病率进行分层，并使用泊松回归调整率比。使用 Cox 回归对全因死亡率进行建模，并使用条件逻辑回归将诊断时的特征与随机选择的非ILD 对照匹配进行比较。
共确定了 128 例药物/放射性ILD 新发病例，研究期间的总体发生率密度为每百万人口年 4.1（95%置信区间 3.4-4.9）。发病率在 1997-2005 年期间增加，此后下降。与对照组相比，病例的全因死亡率调整后高出 4 倍以上。
这项英国基于人群的研究描述了诊断为药物/放射性ILD 的患者，并量化了 1997-2008 年期间的发病率和全因死亡率。尽管在研究期间观察到发病率呈上升趋势，但未发现发病率的统计学显著时间趋势。需要使用 GPRD 和其他数据源进行未来研究，以更好地了解诊断为药物/放射性ILD 的患者的处置情况，并调查随时间推移的潜在发病率和死亡率趋势。
