The predictive prognostic factors for polymyositis/dermatomyositis-associated interstitial lung disease
Posted on 2018-01-11 - 05:00
Abstract Background Interstitial lung disease (ILD) is the principal cause of death in polymyositis/dermatomyositis (PM/DM). Here we investigated prognostic factors for death and serious infection in PM/DM-ILD using the multicenter database. Methods We retrospectively reviewed baseline demographic, clinical and laboratory findings, treatment regimens and outcomes in patients with PM/DM-ILD. The distribution of ILD lesions was evaluated in four divided lung zones of high-resolution computed tomography images. Results Of 116 patients with PM/DM-ILD, 14 died within 6 months from the diagnosis. As independent risk factors for early death, extended ILD lesions in upper lung fields (odds ratio (OR) 8.01, p = 0.016) and hypocapnia (OR 6.85, p = 0.038) were identified. Serious infection was found in 38 patients, including 11 patients who died of respiratory or multiple infections. The independent risk factors were high serum KL-6 (OR 3.68, p = 0.027), high initial dose of prednisolone (PSL) (OR 4.18, p = 0.013), and combination immunosuppressive therapies (OR 5.51, p < 0.001). Conclusion The present study shows the progression of ILD at baseline is the most critical for survival and that infection, especially respiratory infection, is an additive prognostic factor under the potent immunosuppressive treatment.
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Sugiyama, Yumiko; Yoshimi, Ryusuke; Tamura, Maasa; Takeno, Mitsuhiro; Kunishita, Yosuke; Kishimoto, Daiga; et al. (2018). The predictive prognostic factors for polymyositis/dermatomyositis-associated interstitial lung disease. figshare. Collection. https://doi.org/10.6084/m9.figshare.c.3975195.v1
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AUTHORS (23)
YS
Yumiko Sugiyama
RY
Ryusuke Yoshimi
MT
Maasa Tamura
MT
Mitsuhiro Takeno
YK
Yosuke Kunishita
DK
Daiga Kishimoto
YY
Yuji Yoshioka
KK
Kouji Kobayashi
KT
Kaoru Takase-Minegishi
TW
Toshiyuki Watanabe
NH
Naoki Hamada
HN
Hideto Nagai
NT
Naomi Tsuchida
YS
Yutaro Soejima
HN
Hiroto Nakano
RK
Reikou Kamiyama
TU
Takeaki Uehara
YK
Yohei Kirino
AS
Akiko Sekiguchi
AI
Atsushi Ihata