Rheumatoid arthritis related interstitial lung disease - improving outcomes over 25 years: a large multicentre UK study.

Autor:	Kelly CA; Department of Cellular Medicine, University of Newcastle upon Tyne, Gateshead, UK., Nisar M; Rheumatology, Burton Hospitals NHS Foundation Trust, Burton on Trent, UK., Arthanari S; Rheumatology, Burton Hospitals NHS Foundation Trust, Burton on Trent, UK., Carty S; Rheumatology, Great Western Hospital NHS Foundation Trust, Swindon, UK., Woodhead FA; Chest Medicine, University Hospital Leicester NHS Foundation Trust, Leicester, UK., Price-Forbes A; Chest Medicine, University Hospital Leicester NHS Foundation Trust, Leicester, UK., Middleton D; Chest Medicine, University of Aberdeen, UK., Dempsey O; Chest Medicine, University of Aberdeen, UK., Miller D; Chest Medicine, University of Aberdeen, UK., Basu N; Rheumatology, Royal Hospital, Aberdeen, UK., Dawson J; Rheumatology, St Helens and Knowsley Teaching Hospitals NHS Trust, Knowsley, UK., Sathi N; Rheumatology, St Helens and Knowsley Teaching Hospitals NHS Trust, Knowsley, UK., Ahmad Y; Rheumatology, North Wales Hospitals Trust, Betsy-Coed, UK., Palmer E; Medicine, Northern Deanery, Health Education North East, Newcastle, UK., Iqbal K; Medicine, Northern Deanery, Health Education North East, Newcastle, UK., Janakiraman G; Rheumatology, James Cook University Hospital, Middlesbrough, UK., Koduri G; Rheumatology, Southend Hospital, Westcliff-on-Sea, UK., Young A; Rheumatology, St Albans City Hospital, St Albans, UK.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2021 Apr 06; Vol. 60 (4), pp. 1882-1890.
DOI:	10.1093/rheumatology/keaa577
Abstrakt:	Objective: This study explores whether the prognosis of interstitial lung disease in rheumatoid arthritis (RA-ILD) has improved over time and assesses the potential influence of drug therapy in a large multicentre UK network. Methods: We analysed data from 18 UK centres on patients meeting criteria for both RA and ILD diagnosed over a 25-year period. Data included age, disease duration, outcome and cause of death. We compared all cause and respiratory mortality between RA controls and RA-ILD patients, assessing the influence of specific drugs on mortality in four quartiles based on year of diagnosis. Results: A total of 290 RA-ILD patients were identified. All cause (respiratory) mortality was increased at 30% (18%) compared with controls 21% (7%) (P =0.02). Overall, prognosis improved over quartiles with median age at death rising from 63 years to 78 years (P =0.01). No effect on mortality was detected as a result of DMARD use in RA-ILD. Relative risk (RR) of death from any cause was increased among patients who had received anti-TNF therapy [2.09 (1.1-4.0)] P =0.03, while RR was lower in those treated with rituximab [0.52(0.1-2.1)] or mycophenolate [0.65 (0.2-2.0)]. Patients receiving rituximab as their first biologic had longer three (92%), five (82%) and seven year (80%) survival than those whose first biologic was an anti-TNF agent (82%, 76% and 64%, respectively) (P =0.037). Discussion: This large retrospective multicentre study demonstrates survival of patients with RA-ILD has improved. This may relate to the increasing use of specific immunosuppressive and biologic agents. (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu