Hospital Universitario Lucus Augusti, Rúa Dr. Ulises Romero, 1, 27003, Lugo, Spain.
Hospital de La Santa Creu I Sant Pau, Barcelona, Spain.
Sci Rep. 2021 Apr 28;11(1):9184. doi: 10.1038/s41598-021-88734-2.
Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01-1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09-1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73-0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39-0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59-13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03-1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14-4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.
类风湿关节炎(RA)是一种系统性自身免疫性疾病,其主要的关节外受累器官是肺部,有时表现为弥漫性间质性肺疾病(ILD),并影响预后。这是一项多中心、观察性、描述性和横断面研究,纳入了连续诊断为 RA-ILD 的患者。分析了人口统计学、分析、呼吸功能和演变特征,以评估进展和死亡的预测因素。共纳入 106 例患者。多变量分析显示,诊断延迟是死亡的独立预测因素(HR 1.11,95%CI 1.01-1.23,p=0.035)。此外,年龄(HR 1.33,95%CI 1.09-1.62,p=0.0045)、DLCO(%)(HR 0.85,95%CI 0.73-0.98,p=0.0246)和 6MWT 终末 SatO2(%)(HR 0.62,95%CI 0.39-0.99,p=0.0465)是死亡的独立预测变量,GAP 指数(HR 4.65,95%CI 1.59-13.54,p=0.0051)和 CPI 指数(HR 1.12,95%CI 1.03-1.22,p=0.0092)也是如此。在 COX 分析中,ILD 诊断后停用 MTX 或 LFN 与疾病进展相关(HR 2.18,95%CI 1.14-4.18,p=0.019)。这是第一项强调 RA-ILD 诊断延迟与 IPF 一样与死亡率增加相关的研究。
Curr Opin Rheumatol. 2020-5
Front Med (Lausanne). 2025-8-5
Rheumatology (Oxford). 2021-4-6
N Engl J Med. 2019-9-29
Eur Respir J. 2019-1-3
Clin Rheumatol. 2018-10-2