PMID- 34897197
OWN - NLM
STAT- MEDLINE
DCOM- 20220224
LR  - 20230927
IS  - 1536-7355 (Electronic)
IS  - 1076-1608 (Print)
IS  - 1076-1608 (Linking)
VI  - 28
IP  - 2
DP  - 2022 Mar 1
TI  - Variables Associated With Response to Therapy in Patients With Interstitial 
      Pneumonia With Autoimmune Features.
PG  - 84-88
LID - 10.1097/RHU.0000000000001808 [doi]
AB  - BACKGROUND/OBJECTIVE: We have limited knowledge regarding characteristics of 
      patients with interstitial pneumonia with autoimmune features (IPAF) that are 
      associated with response to immunosuppression. In this study, we used published 
      IPAF criteria to characterize features associated with response to treatment. 
      METHODS: We conducted a single-center medical records review study of 63 IPAF 
      patients to evaluate for serological, clinical, and morphological characteristics 
      that are associated with response to immunosuppression. Response was defined as % 
      relative functional vital capacity decline of less than 10% and absence of death 
      or lung transplant within the first year of continuous immunosuppressive therapy. 
      Nonparametric measures of association and multivariate logistic regression were 
      used to evaluate the relationship between baseline characteristics and 
      immunosuppressive response. RESULTS: There was a trend of greater progression 
      among men, ever smokers, those negative for antisynthetase antibodies, and those 
      with usual interstitial pneumonia radiographic pattern, but no statistically 
      significant relationship was found between baseline serological, clinical, or 
      morphological features and response to immunosuppression. Patients on combination 
      therapy with mycophenolate mofetil and prednisone had less disease progression (p 
      = 0.018) than those on regimens that did not include both of these medications. 
      CONCLUSIONS: In our cohort, baseline clinical assessment did not identify which 
      patients with IPAF will respond to immunosuppressive therapy. Combination therapy 
      with mycophenolate mofetil and prednisone was associated with lack of disease 
      progression in our IPAF patients, including in IPAF-usual interstitial pneumonia. 
      Further studies are needed to evaluate which IPAF patients would benefit from 
      immunosuppressive therapy, antifibrotic therapy, or a combination of both.
CI  - Copyright (c) 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Joerns, Elena K
AU  - Joerns EK
AD  - From the Divisions of Rheumatic Diseases.
FAU - Adams, Traci N
AU  - Adams TN
AD  - Pulmonary and Critical Care Medicine, Department of Internal Medicine.
FAU - Newton, Chad A
AU  - Newton CA
AD  - Pulmonary and Critical Care Medicine, Department of Internal Medicine.
FAU - Bermas, Bonnie
AU  - Bermas B
AD  - Division of Cardiothoracic Imaging, Department of Radiology.
FAU - Karp, David
AU  - Karp D
AD  - From the Divisions of Rheumatic Diseases.
FAU - Batra, Kiran
AU  - Batra K
AD  - Division of Cardiothoracic Imaging, Department of Radiology.
FAU - Torrealba, Jose
AU  - Torrealba J
AD  - Surgical Pathology, Immunohistochemistry, and Histology Laboratories and Anatomic 
      Pathology, Department of Pathology.
FAU - Davila, Lesley
AU  - Davila L
FAU - Reisch, Joan
AU  - Reisch J
AD  - Division of Biostatistics, Department of Population and Data Sciences, University 
      of Texas Southwestern Medical Center, Dallas, TX.
FAU - Glazer, Craig
AU  - Glazer C
AD  - Pulmonary and Critical Care Medicine, Department of Internal Medicine.
FAU - Makris, Una E
AU  - Makris UE
AD  - From the Divisions of Rheumatic Diseases.
LA  - eng
GR  - K23 HL148498/HL/NHLBI NIH HHS/United States
GR  - T32 HL098040/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - J Clin Rheumatol
JT  - Journal of clinical rheumatology : practical reports on rheumatic & 
      musculoskeletal diseases
JID - 9518034
RN  - HU9DX48N0T (Mycophenolic Acid)
SB  - IM
MH  - *Autoimmune Diseases
MH  - Humans
MH  - *Idiopathic Pulmonary Fibrosis/complications
MH  - *Lung Diseases, Interstitial/complications/diagnosis/drug therapy
MH  - Male
MH  - Mycophenolic Acid/therapeutic use
MH  - Retrospective Studies
PMC - PMC8860209
MID - NIHMS1747666
COIS- E.K.J. reports salary support from a grant from Pfizer, Inc and Ruth L. 
      Kirschstein Institutional National Research Service Award (T32). C.A.N. reports 
      career development award from the National Heart, Lung, and Blood Institute 
      (K23HL148498) and have received consulting fees from Boehringer-Ingelheim in the 
      amount less than $10,000. U.E.M. reports funding by VA HSR&D and NIA for research 
      unrelated to this work/manuscript with no other conflicts of interest. The other 
      authors declare no conflict of interest.
EDAT- 2021/12/14 06:00
MHDA- 2022/02/25 06:00
PMCR- 2022/02/21
CRDT- 2021/12/13 13:12
PHST- 2021/12/14 06:00 [pubmed]
PHST- 2022/02/25 06:00 [medline]
PHST- 2021/12/13 13:12 [entrez]
PHST- 2022/02/21 00:00 [pmc-release]
AID - 00124743-202203000-00005 [pii]
AID - JCR_210105 [pii]
AID - 10.1097/RHU.0000000000001808 [doi]
PST - ppublish
SO  - J Clin Rheumatol. 2022 Mar 1;28(2):84-88. doi: 10.1097/RHU.0000000000001808.