Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
Por:
Cano-Jiménez E, Vázquez Rodríguez T, Martín-Robles I, Castillo Villegas D, Juan García J, Bollo de Miguel E, Robles-Pérez A, Ferrer Galván M, Mouronte Roibas C, Herrera Lara S, Bermudo G, García Moyano M, Rodríguez Portal JA, Sellarés Torres J, Narváez J and Molina-Molina M
Publicada:
28 abr 2021
Ahead of Print:
28 abr 2021
Categoría:
Multidisciplinary
Resumen:
Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01-1.23, p=0.035). Also, age (HR 1.33, 95% CI 1.09-1.62, p=0.0045), DLCO (%) (HR 0.85, 95% CI 0.73-0.98, p=0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39-0.99, p=0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59-13.54, p=0.0051) and CPI index (HR 1.12, 95% CI 1.03-1.22, p=0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14-4.18, p=0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.
Filiaciones:
Cano-Jiménez E:
Hospital Universitario Lucus Augusti, Rúa Dr. Ulises Romero, 1, 27003, Lugo, Spain.
Vázquez Rodríguez T:
Hospital Universitario Lucus Augusti, Rúa Dr. Ulises Romero, 1, 27003, Lugo, Spain
Martín-Robles I:
Hospital Universitario Lucus Augusti, Rúa Dr. Ulises Romero, 1, 27003, Lugo, Spain
Castillo Villegas D:
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Juan García J:
Complejo Asistencial Universitario de León, León, Spain
Bollo de Miguel E:
Complejo Asistencial Universitario de León, León, Spain
Robles-Pérez A:
Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
Ferrer Galván M:
Hospital Universitario Virgen Macarena, Sevilla, Spain
Mouronte Roibas C:
Complejo Hospitalario Universitario de Vigo, Pontevedra, Spain
:
Hospital Universitario Dr. Peset, Valencia, Spain
Bermudo G:
Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
García Moyano M:
Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
Rodríguez Portal JA:
Hospital Universitario Virgen del Rocío, Sevilla, Spain
Sellarés Torres J:
Hospital Clinic, Barcelona, Spain
Narváez J:
Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
Molina-Molina M:
Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet del Llobregat, Barcelona, Spain
gold, Green Published, Green Submitted
|