Predictive factors for interstitial lung disease progression in a Singapore systemic sclerosis cohort: a multicentre study.

Autor:	Noviani M; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore., Saffari SE; Center for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore., Teng GG; Division of Rheumatology, Department of Medicine, National University Hospital, National University Health System, Singapore., Lim XR; Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore., Chan GYL; Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore., Santosa A; Division of Rheumatology, Department of Medicine, National University Hospital, National University Health System, Singapore., Hong C; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore., Ng SA; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore., Low AHL; Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.
Jazyk:	angličtina
Zdroj:	Singapore medical journal [Singapore Med J] 2024 Oct 22. Date of Electronic Publication: 2024 Oct 22.
DOI:	10.4103/singaporemedj.SMJ-2023-225
Abstrakt:	Introduction: Interstitial lung disease (ILD) in systemic sclerosis (SSc) is heterogeneous with varied progression rate. This study aimed to identify the baseline clinical characteristics associated with ILD progression within 1, 3 and 5 years of the diagnosis of ILD. Methods: This was a prospective, multicentre study - Systematic Sclerosis Cohort Singapore - conducted from January 2008 to February 2021, which included SSc patients with ILD diagnosed by high-resolution computed tomography. Progression of ILD was defined by forced vital capacity (FVC) decline ≥10% predicted or FVC decline 5%-9% predicted, with diffusing lung capacity of carbon monoxide decline ≥15% from the time of ILD diagnosis. Multivariable logistic and Cox regression analyses, adjusting for malignancy and treatment, were performed to determine independent risk factors of ILD progression. Results: Of 124 SSc patients with ILD, 47.6% had limited cutaneous SSc, 33.9% had diffuse SSc and 18.5% had SSc-overlap. Progression of ILD was seen in 6%, 15% and 23% of patients within 1, 3 and 5 years, respectively. After adjusting for malignancy and treatment, anti-La was associated with ILD progression within 1 year (odds ratio [OR] 6.94, 95% confidence interval [CI]: 1.14-42.2; P = 0.04) and 3 years (OR 5.98, 95% CI: 1.31-27.4; P = 0.02), and anti-Scl-70 was associated with ILD progression within 5 years (OR 2.54, 95% CI: 1.05-6.12; P = 0.04). Analysing time to ILD progression as an outcome, anti-La was significantly associated with higher risk of ILD progression (hazard ratio 3.47, 95% CI: 1.18-10.2; P = 0.02). Time to ILD progression was 1.4 years in patients with anti-La versus 6.9 years in patients without anti-La (P = 0.02), and 4.7 years in patients with anti-Scl-70 versus 8.9 years in patients without anti-Scl-70 (P = 0.12). Conclusion: In this Asian cohort of SSc patients, autoantibodies may help to predict ILD progression rates. (Copyright © 2024 Copyright: © 2024 Singapore Medical Journal.)
Databáze:	MEDLINE
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