Journal
RHEUMATOLOGY
Volume 60, Issue 5, Pages 2348-2354Publisher
OXFORD UNIV PRESS
DOI: 10.1093/rheumatology/keaa608
Keywords
interstitial lung disease; acute exacerbation; usual interstitial pneumonia; MTX; RA
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Funding
- National Center for Global Health and Medicine [29-2001]
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This study retrospectively analyzed the clinical characteristics and risk factors of ILD-AE in 165 RA-ILD patients. The results showed a significant association between the UIP pattern and the occurrence of ILD-AE and mortality.
Objectives. RA-associated interstitial lung disease (RA-ILD) is commonly associated with acute exacerbations (ILD-AE). This study examined the clinical characteristics and risk factors of ILD-AE and mortality of RA-ILD. Methods. We retrospectively collected data on 165 RA-ILD patients who visited or were admitted to our hospital between January 2007 and December 2019. We compared the clinical characteristics of patients who did and did not develop ILD-AE and identified variables significantly associated with ILD-AE. We also compared the admission characteristics of those who survived and those who died after admission for ILD-AE. ILD-AE was defined using previously proposed criteria, modified slightly for application to RA-ILD. Results. The mean patient age was 73.6 years (s.b. 9.7) and 97 (71.9%) patients were female. Thirty (22.2%) patients developed ILD-AE, 13 (43.3%) of whom died. In univariate analyses, neither the usual interstitial pneumonia (UIP) pattern nor MTX was associated with ILD-AE. In multivariate analyses, the UIP pattern was significantly associated with ILD-AE [odds ratio (OR) 2.55 (95% CI 1.05, 6.20), P =0.038]. In the Cox proportional hazards model, the UIP pattern [hazard ratio (HR) 4.67 (95% CI 1.02, 21.45), P =0.048] was significantly associated with death, while MTX use [HR 0.16 (95% CI 0.04, 0.72), P =0.016] was significantly associated with survival. Conclusion. Our data suggest that the UIP pattern is related to ILD-AE. Furthermore, both the UIP pattern and non-use of MTX might be related to death from ILD-AE in RA-ILD.
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