原发性干燥综合征相关间质性肺病的疾病修饰抗风湿药物疗效。
Efficacy of disease-modifying antirheumatic drugs in primary Sjögren's syndrome-related interstitial lung disease.
机构信息
Akdeniz University School of Medicine, Department of Internal Medicine, Division of Rheumatology, Antalya, Turkey.
Department of Rheumatology, Antalya City Hospital, Antalya, Turkey.
出版信息
Med Clin (Barc). 2024 Nov 29;163(10):490-495. doi: 10.1016/j.medcli.2024.06.012. Epub 2024 Aug 22.
OBJECTIVES
To evaluate the treatment modalities and their effects in primary Sjögren's syndrome (pSS) patients with interstitial lung disease (ILD).
METHODS
In this chart review study, patients diagnosed with pSS-related ILD (pSS-ILD) between January 2004 and August 2022 were screened. Glucocorticoid use and administered disease-modifying antirheumatic drugs (DMARDs) were determined. The difference between forced vital capacity (FVC) and diffusion capacity of the lungs for carbon monoxide (DLCO) before and after treatment was evaluated.
RESULTS
ILD was present in 44 of 609 patients (7.2%) diagnosed with pSS. In 27 patients included in the study, steroid usage was 81.5%. There was a statistically insignificant increase in FVC% (from 80.20±22.1 to 81.6±23.0) and a decrease in DLCO% (53.7±15.3-52.2±19.3) with DMARD treatment (p=0.434 and p=0.652, respectively). There was no significant difference between the treatment groups (azathioprine [AZA], mycophenolate mofetil [MMF], and rituximab [RTX]) in terms of the change in FVC% and DLCO% compared with baseline levels. The effect of treatment on FVC and DLCO was similar in UIP and NSIP patterns.
CONCLUSIONS
AZA, MMF, and RTX have similar effects on pulmonary functions in pSS-ILD and provide disease stabilization.
目的
评估原发性干燥综合征（pSS）合并间质性肺疾病（ILD）患者的治疗方式及其疗效。
方法
在这项回顾性研究中，筛选了 2004 年 1 月至 2022 年 8 月期间诊断为 pSS 相关 ILD（pSS-ILD）的患者。确定了糖皮质激素的使用情况和应用的改善病情抗风湿药物（DMARDs）。评估了治疗前后用力肺活量（FVC）和一氧化碳弥散量（DLCO）的差异。
结果
在 609 例诊断为 pSS 的患者中，ILD 的发生率为 7.2%（44 例）。在纳入研究的 27 例患者中，激素使用率为 81.5%。DMARD 治疗后 FVC%（从 80.20±22.1 增加到 81.6±23.0）和 DLCO%（从 53.7±15.3 降低到 52.2±19.3）有统计学上的无显著差异（p=0.434 和 p=0.652）。与基线水平相比，在 FVC%和 DLCO%的变化方面，AZA、MMF 和 RTX 三种治疗组之间无显著差异。在 UIP 和 NSIP 模式下，治疗对 FVC 和 DLCO 的影响相似。
结论
AZA、MMF 和 RTX 对 pSS-ILD 的肺功能具有相似的作用，可稳定病情。
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