The Predictive Prognostic Factors for Polymyositis/dermatomyositis-associated Interstitial Lung Disease

Overview

Journal Arthritis Res Ther

Publisher Biomed Central

Specialty Rheumatology

Date 2018 Jan 13

PMID 29325580

Citations 31

Authors

Yumiko Sugiyama

Ryusuke Yoshimi

Maasa Tamura

Mitsuhiro Takeno

Yosuke Kunishita

Daiga Kishimoto

Yuji Yoshioka

Kouji Kobayashi

Kaoru Takase-Minegishi

Toshiyuki Watanabe

Naoki Hamada

Hideto Nagai

Naomi Tsuchida

Yutaro Soejima

Hiroto Nakano

Reikou Kamiyama

Takeaki Uehara

Yohei Kirino

Akiko Sekiguchi

Atsushi Ihata

Shigeru Ohno

Shouhei Nagaoka

Hideaki Nakajima

Affiliations

Soon will be listed here.

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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