Interstitial Lung Disease and Rheumatology Unit, DF. Tlalpan, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, Calzada de Tlalpan 4502, Sección XVI, México, México, CP, 14080.
Programa de Maestría y Doctorado en Ciencias Médicas, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico.
Clin Rheumatol. 2022 Jun;41(6):1741-1747. doi: 10.1007/s10067-021-06040-8. Epub 2022 Feb 3.
We hypothesized that RA disease activity might be associated with the survival of RA-ILD patients. To evaluate this possibility, we analyzed data on disease activity during follow-up in an RA-ILD cohort and compared disease activity between surviving patients and those who died during follow-up.
RA-ILD patients referred for medical evaluation and treatment at a single center, with CDAI scores during all follow up were included. We estimated the HR of the mean of the CDAI score during follow-up with survival. Also, we compared the survival function of patients with high disease activity (CDAI scores ≥ 22) during all follow-up with those with moderate and low disease activity.
Thirty-seven patients were included. The mean of the CDAI score during follow-up was higher in death patients (median 30.8 ± 18.5 Vs. 16.8 ± 11.3), and a single unit increase in the mean of the CDAI score was associated with non-survival, HR:1.07 (95% CI: 1.02 -1.12). Patients with high disease activity during all follow-up (CDAI scores > 22) had lower survival function in comparison with moderate and low disease activity (P = 0.042).
The results of the study suggest that higher RA disease activity is associated with a worse prognosis of RA-ILD patients. The hypothesis that high disease activity is associated with worse survival in RA-ILD patients must be evaluated in more extensive cohort studies and clinical trials.
• RA-ILD patients with high disease activity during follow-up had a worse prognosis than those with moderate or low disease activity. • The study results suggest the hypothesis that patients with RA-ILD must be treated with a treat to target strategy, with the aim of remission or low RA disease activity.
我们假设 RA 疾病活动度可能与 RA-ILD 患者的生存相关。为了评估这种可能性，我们分析了 RA-ILD 队列中随访期间疾病活动的数据，并比较了存活患者和随访期间死亡患者的疾病活动度。
纳入在单中心接受医学评估和治疗的 RA-ILD 患者，且所有随访期间均有 CDAI 评分。我们估计了随访期间 CDAI 评分均值与生存的 HR。此外，我们比较了所有随访期间疾病活动度高（CDAI 评分≥22）患者和疾病活动度中、低患者的生存功能。
共纳入 37 例患者。死亡患者的随访期间 CDAI 评分均值更高（中位数 30.8±18.5 比 16.8±11.3），CDAI 评分均值每增加 1 单位与非生存相关，HR：1.07（95%CI：1.02-1.12）。与中、低疾病活动度相比，所有随访期间疾病活动度高（CDAI 评分>22）患者的生存功能较低（P=0.042）。
研究结果提示 RA 疾病活动度较高与 RA-ILD 患者预后较差相关。RA-ILD 患者疾病活动度较高与生存较差相关的假说需要在更广泛的队列研究和临床试验中进行评估。
· 随访期间疾病活动度高的 RA-ILD 患者预后较中、低疾病活动度患者差。
· 研究结果提示 RA-ILD 患者必须采用达标治疗策略，以达到缓解或低 RA 疾病活动度的目标。
