An observational study of clinical recurrence in patients with interstitial lung disease related to the antisynthetase syndrome

Objective To describe the clinical characteristics and risk factors of clinical recurrence in interstitial lung disease related to antisynthetase syndrome (ARS-ILD). Methods Patients diagnosed as ARS-ILD in Nanjing Drum Tower Hospital between January 2015 and November 2020 were retrospectively analyzed. Clinical information and treatment course were reviewed. The primary endpoint was the disease recurrence, and the secondary point was mortality. Univariate and multivariable Cox regression analyses were performed to identify risk factors for recurrence. Results Totally, 132 patients with ARS-ILD received immunomodulation treatment from diagnosis. During follow-ups, sixty-nine patients showed recurrence, with a recurrency rate yielding 52.3%. The median duration from treatment initiation to recurrence was 11 (5–18) months. The median tapering course in the recurrence group was 8 (3–12.5) months, which was significantly shorter than the 16 (10–32) months in the no-recurrence group (p < 0.001). Fifty-eight patients experienced recurrence when the glucocorticoids (GC) dose dropped to 10 (9.375–15) mg/day. Twelve patients discontinued GC with a median treatment course of 11.5 (8–16.75) months, and 11 patients developed recurrence after discontinuing GC for 3 (1–4) months. Twelve patients died, with a mortality rate of 9.1%, and recurrence was not associated with increased mortality. The adjusted multivariate analysis showed that age, increased serum lactate dehydrogenase (LDH) level, relatively shorter tapering duration, and inappropriate GC discontinuation were associated with recurrence. Conclusion Recurrence of ARS-ILD was common during medication intensity reduction. Age, LDH, medication tapering duration, and discontinuation were risk factors for recurrence. Further efforts to reduce recurrence should take into consideration of these factors. Key Points• Recurrence is observed commonly with a recurrency rate 52.3% in patients with interstitial lung disease related to antisynthetase syndrome (ARS-ILD) when glucocorticoids (GC) tapering or discontinuation.• Age, increased serum lactate dehydrogenase (LDH) level, medication tapering duration, and GC discontinuation were identified to be significantly associated with the recurrence of ARS-ILD..

Medienart:	Artikel

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	Zur Gesamtaufnahme - volume:42
Enthalten in:	Clinical rheumatology - 42(2022), 3 vom: 05. Nov., Seite 711-720

Sprache:	Englisch

Beteiligte Personen:	Chen, Haoran [VerfasserIn] Liu, Huarui [VerfasserIn] Lyu, Wenting [VerfasserIn] Liu, Yin [VerfasserIn] Huang, Mei [VerfasserIn] Zhang, Yingwei [VerfasserIn] Qiu, Yuying [VerfasserIn] Xiao, Yonglong [VerfasserIn] Cai, Hourong [VerfasserIn] Dai, Jinghong [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

Themen:	Antisynthetase syndrome Glucocorticoids Recurrence Risk factor

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© The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR) 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:	10.1007/s10067-022-06424-4

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PPN (Katalog-ID):	OLC2133981306