接受JAK抑制剂治疗的类风湿关节炎相关间质性肺疾病患者的病情演变：一项回顾性探索性研究。
Evolution of Rheumatoid-Arthritis-Associated Interstitial Lung Disease in Patients Treated with JAK Inhibitors: A Retrospective Exploratory Study.
作者信息
Venerito Vincenzo, Manfredi Andreina, Carletto Antonio, Gentileschi Stefano, Atzeni Fabiola, Guiducci Serena, Lavista Marlea, La Corte Laura, Pedrollo Elisa, Scardapane Arnaldo, Tomassini Caterina, Frediani Bruno, Salvarani Carlo, Iannone Florenzo, Sebastiani Marco
机构信息
Rheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy.
Rheumatology Unit, Azienda Ospedaliera Policlinico di Modena, University of Modena and Reggio Emilia, 41124 Modena, Italy.
出版信息
J Clin Med. 2023 Jan 26;12(3):957. doi: 10.3390/jcm12030957.
BACKGROUND
The aim of this multicenter retrospective study was to investigate the effectiveness and safety of the available JAK-inhibitors (JAKi) in patients with rheumatoid arthritis (RA) and interstitial lung disease (ILD).
METHODS
We retrospectively analyzed patients with classified RA and RA-ILD undergoing JAKi in 6 Italian tertiary centers from April 2018 to June 2022. We included patients with at least 6 months of active therapy and one high-resolution chest tomography (HRCT) carried out within 3 months of the start of JAKi treatment. The HRCT was then compared to the most recent one carried out within 3 months before the last available follow-up appointment. We also kept track of the pulmonary function tests.
RESULTS
We included 43 patients with RA-ILD and 23 males (53.48%) with a median age (interquartile range, IQR) of 68.87 (61.46-75.78) treated with JAKi. The median follow-up was 19.1 months (11.03-34.43). The forced vital capacity remained stable in 22/28 (78.57%) patients, improved in 3/28 (10.71%) and worsened in 3/28 (10.71%). The diffusing capacity of lung for carbon monoxide showed a similar trend, remaining stable in 18/25 (72%) patients, improving in 2/25 (8%) and worsening in 5/25 (20%). The HRCT remained stable in 37/43 (86.05) cases, worsened in 4/43 (9.30%) and improved in the last 2 (4.65%).
DISCUSSION
This study suggests that JAKi therapy might be a safe therapeutic option for patients with RA-ILD in a short-term follow-up.
背景
这项多中心回顾性研究的目的是调查现有Janus激酶抑制剂（JAKi）治疗类风湿性关节炎（RA）合并间质性肺病（ILD）患者的有效性和安全性。
方法
我们回顾性分析了2018年4月至2022年6月期间在意大利6家三级中心接受JAKi治疗的确诊RA和RA-ILD患者。我们纳入了至少接受6个月积极治疗且在开始JAKi治疗后3个月内进行过一次高分辨率胸部断层扫描（HRCT）的患者。然后将此次HRCT与最后一次可用随访预约前3个月内进行的最近一次HRCT进行比较。我们还记录了肺功能测试结果。
结果
我们纳入了43例RA-ILD患者，其中23例男性（53.48%），接受JAKi治疗的中位年龄（四分位间距，IQR）为68.87（61.46-75.78）岁。中位随访时间为19.1个月（11.03-34.43）。22/28（78.57%）例患者的用力肺活量保持稳定，3/28（10.71%）例改善，3/28（10.71%）例恶化。肺一氧化碳弥散量呈现类似趋势，18/25（72%）例患者保持稳定，2/25（8%）例改善，5/25（20%）例恶化。43例中有37例（86.05%）的HRCT保持稳定，4/43（9.30%）例恶化，最后2例（4.65%）改善。
讨论
本研究表明，在短期随访中，JAKi治疗可能是RA-ILD患者的一种安全治疗选择。
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