Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis


Por: Cano-Jimenez, E, Rodriguez, TV, Martin-Robles, I, Villegas, DC, Garcia, JJ, de Miguel, EB, Robles-Perez, A, Galvan, MF, Roibas, CM, Lara, SH, Bermudo, G, Moyano, MG, Portal, JAR, Torres, JS, Narvaez, J, Molina-Molina, M

Publicada: 28 abr 2021
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-Jimenez, E:
 Hosp Univ Lucus Augusti, Rua Dr Ulises Romero 1, Lugo 27003, Spain

Rodriguez, TV:
 Hosp Univ Lucus Augusti, Rua Dr Ulises Romero 1, Lugo 27003, Spain

Martin-Robles, I:
 Hosp Univ Lucus Augusti, Rua Dr Ulises Romero 1, Lugo 27003, Spain

Villegas, DC:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Garcia, JJ:
 Complejo Asistencial Univ Leon, Leon, Spain

de Miguel, EB:
 Complejo Asistencial Univ Leon, Leon, Spain

Robles-Perez, A:
 Hosp Univ Bellvitge IDIBELL, Barcelona, Spain

Galvan, MF:
 Hosp Univ Virgen Macarena, Seville, Spain

Roibas, CM:
 Complejo Hospitalario Univ Vigo, Pontevedra, Spain

Lara, SH:
 Hosp Univ Dr Peset, Valencia, Spain

Bermudo, G:
 Hosp Univ Bellvitge IDIBELL, Barcelona, Spain

Moyano, MG:
 Hosp Univ Cruces, Baracaldo, Vizcaya, Spain

Portal, JAR:
 Hosp Univ Virgen Rocio, Seville, Spain

Torres, JS:
 Hosp Clin Barcelona, Barcelona, Spain

Narvaez, J:
 Hosp Univ Bellvitge IDIBELL, Barcelona, Spain

Molina-Molina, M:
 Hosp Univ Bellvitge IDIBELL, Barcelona, Spain
ISSN: 20452322
Editorial
NATURE RESEARCH, HEIDELBERGER PLATZ 3, BERLIN, 14197, GERMANY, Reino Unido
Tipo de documento: Article
Volumen: 11 Número: 1
Páginas:
WOS Id: 000656067200006
ID de PubMed: 33911185
imagen Green Published, gold

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