Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort study
Background: Studies on the risk and protective factors for lung function decline and mortality in rheumatoid arthritis–related interstitial lung disease (RA-ILD) are limited. Objectives: We aimed to investigate clinical factors and medication uses associated with lung function decline and mortality...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-11-01
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| Series: | Therapeutic Advances in Respiratory Disease |
| Online Access: | https://doi.org/10.1177/17534666221135314 |
| _version_ | 1797853355765137408 |
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| author | Kangjoon Kim Ala Woo Youngmok Park Seung Hyun Yong Su Hwan Lee Sang Hoon Lee Ah Young Leem Song Yee Kim Kyung Soo Chung Eun Young Kim Ji Ye Jung Young Ae Kang Young Sam Kim Moo Suk Park |
| author_facet | Kangjoon Kim Ala Woo Youngmok Park Seung Hyun Yong Su Hwan Lee Sang Hoon Lee Ah Young Leem Song Yee Kim Kyung Soo Chung Eun Young Kim Ji Ye Jung Young Ae Kang Young Sam Kim Moo Suk Park |
| author_sort | Kangjoon Kim |
| collection | DOAJ |
| description | Background: Studies on the risk and protective factors for lung function decline and mortality in rheumatoid arthritis–related interstitial lung disease (RA-ILD) are limited. Objectives: We aimed to investigate clinical factors and medication uses associated with lung function decline and mortality in RA-ILD. Methods: This retrospective cohort study examined the medical records of patients with RA-ILD who visited Severance Hospital between January 2006 and December 2019. We selected 170 patients with RA-ILD who had undergone at least one spirometry test and chest computed tomography scan. An absolute decline of ⩾10% in the functional vital capacity (FVC) was defined as significant decline in pulmonary function. Data for analysis were retrieved from electronic medical records. Results: Ninety patients (52.9%) were female; the mean age was 64.0 ± 10.2 years. Multivariate logistic regression showed that a high erythrocyte sediment rate level at baseline [odds ratio (OR) = 3.056; 95% confidence interval (CI) = 1.183–7.890] and methotrexate (MTX) use (OR = 0.269; 95% CI = 0.094–0.769) were risk and protective factors for lung function decline, respectively. Multivariate Cox regression analysis indicated that age ⩾65 years (OR = 2.723; 95% CI = 1.142–6.491), radiologic pattern of usual interstitial pneumonia (UIP) or probable UIP (OR = 3.948; 95% CI = 1.522–10.242), baseline functional vital capacity (FVC) % predicted (OR = 0.971; 95% CI = 0.948–0.994), and MTX use (OR = 0.284; 95% CI = 0.091–0.880) were predictive of mortality. Conclusion: We identified risk and protective factors for lung function decline and mortality in patients with RA-ILD. MTX use was associated with favorable outcome in terms of both lung function and mortality in our cohort. |
| first_indexed | 2024-04-09T19:48:14Z |
| format | Article |
| id | doaj.art-fb8c4f2efb634f9393d5e9b633a9d0d2 |
| institution | Directory Open Access Journal |
| issn | 1753-4666 |
| language | English |
| last_indexed | 2024-04-09T19:48:14Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Respiratory Disease |
| spelling | doaj.art-fb8c4f2efb634f9393d5e9b633a9d0d22023-04-03T13:35:26ZengSAGE PublishingTherapeutic Advances in Respiratory Disease1753-46662022-11-011610.1177/17534666221135314Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort studyKangjoon KimAla WooYoungmok ParkSeung Hyun YongSu Hwan LeeSang Hoon LeeAh Young LeemSong Yee KimKyung Soo ChungEun Young KimJi Ye JungYoung Ae KangYoung Sam KimMoo Suk ParkBackground: Studies on the risk and protective factors for lung function decline and mortality in rheumatoid arthritis–related interstitial lung disease (RA-ILD) are limited. Objectives: We aimed to investigate clinical factors and medication uses associated with lung function decline and mortality in RA-ILD. Methods: This retrospective cohort study examined the medical records of patients with RA-ILD who visited Severance Hospital between January 2006 and December 2019. We selected 170 patients with RA-ILD who had undergone at least one spirometry test and chest computed tomography scan. An absolute decline of ⩾10% in the functional vital capacity (FVC) was defined as significant decline in pulmonary function. Data for analysis were retrieved from electronic medical records. Results: Ninety patients (52.9%) were female; the mean age was 64.0 ± 10.2 years. Multivariate logistic regression showed that a high erythrocyte sediment rate level at baseline [odds ratio (OR) = 3.056; 95% confidence interval (CI) = 1.183–7.890] and methotrexate (MTX) use (OR = 0.269; 95% CI = 0.094–0.769) were risk and protective factors for lung function decline, respectively. Multivariate Cox regression analysis indicated that age ⩾65 years (OR = 2.723; 95% CI = 1.142–6.491), radiologic pattern of usual interstitial pneumonia (UIP) or probable UIP (OR = 3.948; 95% CI = 1.522–10.242), baseline functional vital capacity (FVC) % predicted (OR = 0.971; 95% CI = 0.948–0.994), and MTX use (OR = 0.284; 95% CI = 0.091–0.880) were predictive of mortality. Conclusion: We identified risk and protective factors for lung function decline and mortality in patients with RA-ILD. MTX use was associated with favorable outcome in terms of both lung function and mortality in our cohort.https://doi.org/10.1177/17534666221135314 |
| spellingShingle | Kangjoon Kim Ala Woo Youngmok Park Seung Hyun Yong Su Hwan Lee Sang Hoon Lee Ah Young Leem Song Yee Kim Kyung Soo Chung Eun Young Kim Ji Ye Jung Young Ae Kang Young Sam Kim Moo Suk Park Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort study Therapeutic Advances in Respiratory Disease |
| title | Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort study |
| title_full | Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort study |
| title_fullStr | Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort study |
| title_full_unstemmed | Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort study |
| title_short | Protective effect of methotrexate on lung function and mortality in rheumatoid arthritis–related interstitial lung disease: a retrospective cohort study |
| title_sort | protective effect of methotrexate on lung function and mortality in rheumatoid arthritis related interstitial lung disease a retrospective cohort study |
| url | https://doi.org/10.1177/17534666221135314 |
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