Prognostic factors of fungal infection in anti-melanoma differentiation-associated gene 5 antibody-positive associated interstitial lung disease
Objective To investigate the potential risk factors for mortality in fungal infection in anti-melanoma differentiation-associated gene 5 antibody-positive associated interstitial lung disease (MDA5-ILD). Methods Patients diagnosed with MDA5-ILD from April 2017 to November 2022 were included. The demographic data, laboratory examinations, therapeutic and follow-up information were recorded. Fungal infection diagnosis was established based on a combinations of host factors, clinical features and mycologic evidences. High-dose corticosteroid therapy was defined as the initial corticosteroid doses > 240mg/d. The primary endpoint was mortality. Potential factors for fungal infection occurrence and prognostic factors were analyzed using logistic regression analysis and Cox proportional hazards regression. Results In total, 121 patients with MDA5-ILD were included. During follow-up, 41 (33.9%) patients had suffered fungal infection and 39.0% (16/41) of whom had ever received high-dose corticosteroid therapy. The median interval from corticosteroid use to the occurrence of fungal infection was 29 (10–48) days. The mean survival time of patients with fungal infection was 234.32 ± 464.76 days. The mortality in MDA5-ILD with fungal infection was 85.4% (35/41), which was significantly higher than those without (85.4% VS 56.3%, P < 0.001). High-dose corticosteroid therapy (P = 0.049) was independent risk factor for fungal infection occurrence. Decreased serum albumin level (P = 0.024) and high-dose corticosteroid therapy (P = 0.008) were both associated with increased mortality in MDA5-ILD patients with fungal infection. Conclusion Fungal infection is associated with an increased mortality in MDA5-ILD. The serum albumin level and corticosteroid dose should be taken into consideration when treating MDA5-ILD. Key Points• This study showed fungal infection is associated with an increased mortality in MDA5-ILD. In MDA5-ILD patients with fungal infection, the presence of decreased serum albumin level and high-dose corticosteroid therapy were identified as predictors for mortality..
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
|---|---|
| Enthalten in: |
Clinical rheumatology - 43(2024), 4 vom: 12. Feb., Seite 1381-1392 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Zhou, Wanqing [VerfasserIn] |
|---|
| Links: |
Volltext [lizenzpflichtig] |
|---|
| BKL: | |
|---|---|
| Themen: |
Anti-MDA5 |
| Anmerkungen: |
© The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR) 2024. 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/s10067-024-06899-3 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
SPR055186327 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | SPR055186327 | ||
| 003 | DE-627 | ||
| 005 | 20240318064619.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240318s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s10067-024-06899-3 |2 doi | |
| 035 | |a (DE-627)SPR055186327 | ||
| 035 | |a (SPR)s10067-024-06899-3-e | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 082 | 0 | 4 | |a 610 |q VZ |
| 082 | 0 | 4 | |a 610 |q VZ |
| 084 | |a 44.00 |2 bkl | ||
| 084 | |a 44.83 |2 bkl | ||
| 100 | 1 | |a Zhou, Wanqing |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic factors of fungal infection in anti-melanoma differentiation-associated gene 5 antibody-positive associated interstitial lung disease |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a © The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR) 2024. 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. | ||
| 520 | |a Objective To investigate the potential risk factors for mortality in fungal infection in anti-melanoma differentiation-associated gene 5 antibody-positive associated interstitial lung disease (MDA5-ILD). Methods Patients diagnosed with MDA5-ILD from April 2017 to November 2022 were included. The demographic data, laboratory examinations, therapeutic and follow-up information were recorded. Fungal infection diagnosis was established based on a combinations of host factors, clinical features and mycologic evidences. High-dose corticosteroid therapy was defined as the initial corticosteroid doses > 240mg/d. The primary endpoint was mortality. Potential factors for fungal infection occurrence and prognostic factors were analyzed using logistic regression analysis and Cox proportional hazards regression. Results In total, 121 patients with MDA5-ILD were included. During follow-up, 41 (33.9%) patients had suffered fungal infection and 39.0% (16/41) of whom had ever received high-dose corticosteroid therapy. The median interval from corticosteroid use to the occurrence of fungal infection was 29 (10–48) days. The mean survival time of patients with fungal infection was 234.32 ± 464.76 days. The mortality in MDA5-ILD with fungal infection was 85.4% (35/41), which was significantly higher than those without (85.4% VS 56.3%, P < 0.001). High-dose corticosteroid therapy (P = 0.049) was independent risk factor for fungal infection occurrence. Decreased serum albumin level (P = 0.024) and high-dose corticosteroid therapy (P = 0.008) were both associated with increased mortality in MDA5-ILD patients with fungal infection. Conclusion Fungal infection is associated with an increased mortality in MDA5-ILD. The serum albumin level and corticosteroid dose should be taken into consideration when treating MDA5-ILD. Key Points• This study showed fungal infection is associated with an increased mortality in MDA5-ILD. In MDA5-ILD patients with fungal infection, the presence of decreased serum albumin level and high-dose corticosteroid therapy were identified as predictors for mortality. | ||
| 650 | 4 | |a Anti-MDA5 |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Fungal infection |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Idiopathic inflammatory myopathies |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Interstitial lung disease |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Chen, Haoran |4 aut | |
| 700 | 1 | |a Ji, Tong |4 aut | |
| 700 | 1 | |a Chen, Ranxun |4 aut | |
| 700 | 1 | |a Xu, Qingqing |4 aut | |
| 700 | 1 | |a Chen, Lulu |4 aut | |
| 700 | 1 | |a Cao, Min |4 aut | |
| 700 | 1 | |a Cai, Hourong |4 aut | |
| 700 | 1 | |a Dai, Jinghong |0 (orcid)0000-0003-3165-0623 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical rheumatology |d Springer International Publishing, 1982 |g 43(2024), 4 vom: 12. Feb., Seite 1381-1392 |w (DE-627)SPR008480389 |w (DE-600)1480901-1 |x 1434-9949 |7 nnns |
| 773 | 1 | 8 | |g volume:43 |g year:2024 |g number:4 |g day:12 |g month:02 |g pages:1381-1392 |
| 856 | 4 | 0 | |u https://dx.doi.org/10.1007/s10067-024-06899-3 |z lizenzpflichtig |3 Volltext |
| 912 | |a GBV_SPRINGER | ||
| 912 | |a SSG-OLC-PHA | ||
| 936 | b | k | |a 44.00 |q VZ |
| 936 | b | k | |a 44.83 |q VZ |
| 951 | |a AR | ||
| 952 | |d 43 |j 2024 |e 4 |b 12 |c 02 |h 1381-1392 | ||