PMID- 34536219
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220809
IS  - 2198-6576 (Print)
IS  - 2198-6584 (Electronic)
IS  - 2198-6576 (Linking)
VI  - 8
IP  - 4
DP  - 2021 Dec
TI  - The Risk Factors of Exacerbation in Interstitial Pneumonia With Autoimmune 
      Features: A Single-Center Observational Cohort Study.
PG  - 1693-1710
LID - 10.1007/s40744-021-00371-3 [doi]
AB  - OBJECTIVES: To investigate the long-term outcomes, including risk factors, for 
      exacerbation between monotherapy and combination therapy in patients with 
      interstitial pneumonia with autoimmune features (IPAF). METHODS: We assessed 672 
      patients between April 2009 and March 2019 who were evaluated using 
      high-resolution computed tomography (HRCT) of the chest. We applied the IPAF 
      criteria. Fifty-two patients who visited our department for at least 6 months 
      were diagnosed with IPAF. Clinical, laboratory, and imaging data were collected 
      from medical records and statistically analyzed. RESULTS: Among the 52 cases of 
      IPAF, we compared the characteristics at diagnosis between treated (n = 28) and 
      untreated patients (n = 24). The exacerbation rates were 42.9% (n = 12) and 8.3% 
      (n = 2) (P = 0.0051), respectively. Among the treated patients, smoking history, 
      high titer of KL-6, and the duration from diagnosis to the start of treatment 
      were significant risk factors for exacerbation (P = 0.0062, 0.011, and 0.019, 
      respectively). The number of risk factors was significantly and positively 
      associated with exacerbation rate (P = 0.0053). Among the treated patients, 
      glucocorticoid (GC) monotherapy was used in 13 cases, and GC and 
      immunosuppressant (IS) combination therapy was used in 14 patients. There was no 
      significant difference in the treatment methods between patients with and without 
      risk factors (P = 0.47). When comparing the long-term outcomes between the 
      monotherapy and combination therapy groups, the 3-year non-exacerbation rates 
      were 72.9 and 45.9% (P = 0.020), respectively. CONCLUSIONS: IPAF patients with 
      risk factors had a high exacerbation rate, regardless of the type of treatment. 
      New interventions aimed at preventing exacerbations in these patients are 
      required.
CI  - (c) 2021. The Author(s).
FAU - Murata, Okinori
AU  - Murata O
AUID- ORCID: 0000-0001-5343-5444
AD  - Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal 
      Medicine, Iwate Medical University School of Medicine, 2-1-1 Idaidori Yahaba-chou 
      Shiwa-gun, Morioka, Iwate, 028-3694, Japan.
AD  - Division of Rheumatology, Department of Internal Medicine, Keio University School 
      of Medicine, Tokyo, Japan.
FAU - Suzuki, Katsuya
AU  - Suzuki K
AD  - Division of Rheumatology, Department of Internal Medicine, Keio University School 
      of Medicine, Tokyo, Japan.
FAU - Takeuchi, Tsutomu
AU  - Takeuchi T
AD  - Division of Rheumatology, Department of Internal Medicine, Keio University School 
      of Medicine, Tokyo, Japan.
FAU - Maemondo, Makoto
AU  - Maemondo M
AD  - Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal 
      Medicine, Iwate Medical University School of Medicine, 2-1-1 Idaidori Yahaba-chou 
      Shiwa-gun, Morioka, Iwate, 028-3694, Japan. maemondo@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20210918
PL  - England
TA  - Rheumatol Ther
JT  - Rheumatology and therapy
JID - 101674543
PMC - PMC8572251
OTO - NOTNLM
OT  - Interstitial pneumonia with autoimmune features
OT  - Long-term outcomes
OT  - Prognosis
OT  - Risk factors
OT  - Treatment methods
EDAT- 2021/09/19 06:00
MHDA- 2021/09/19 06:01
PMCR- 2021/09/18
CRDT- 2021/09/18 12:11
PHST- 2021/07/13 00:00 [received]
PHST- 2021/09/02 00:00 [accepted]
PHST- 2021/09/19 06:00 [pubmed]
PHST- 2021/09/19 06:01 [medline]
PHST- 2021/09/18 12:11 [entrez]
PHST- 2021/09/18 00:00 [pmc-release]
AID - 10.1007/s40744-021-00371-3 [pii]
AID - 371 [pii]
AID - 10.1007/s40744-021-00371-3 [doi]
PST - ppublish
SO  - Rheumatol Ther. 2021 Dec;8(4):1693-1710. doi: 10.1007/s40744-021-00371-3. Epub 
      2021 Sep 18.