| Title: |
Preventive effects of early immunosuppressive treatment on the development of interstitial lung disease in systemic sclerosis. |
| Authors: |
Velauthapillai, A.; Bootsma, M. F. R.; Bruni, C.; Bergmann, C.; Matucci-Cerinic, M.; Launay, David; Riemekastan, G.; Garzanova, L.; Airò, P.; Rezus, E.; da Silva, J. A. P.; del Galdo, F.; Hunzelmann, N.; Chung, L. S.; Krasowska, D.; Distler, O.; van den Ende, C. H. M.; Vonk, M. C. |
| Contributors: |
Radboud University Medical Center Nijmegen (RadboudUMC); University hospital of Zurich Zurich; Università degli Studi di Firenze = University of Florence = Université de Florence (UniFI); Universitätsklinikum Erlangen Erlangen; Universita Vita Salute San Raffaele = Vita-Salute San Raffaele University Milan, Italie (UniSR); Lille Inflammation Research International Center - U 995 (LIRIC); Institut Pasteur de Lille; Pasteur Network (Réseau International des Instituts Pasteur)-Pasteur Network (Réseau International des Instituts Pasteur)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Universität zu Lübeck = University of Lübeck Lübeck; Azienda Socio Sanitaria Territoriale Spedali Civili di Brescia Brescia (ASST Spedali Civili di Brescia); University of Medicine and Pharmacy "Grigore T.Popa" Iasi (UMF lasi); Universidade de Coimbra = University of Coimbra Portugal (UC); University of Leeds; Universität zu Köln = University of Cologne; Stanford University; Medical University of Lublin |
| Source: |
ISSN: 1462-0324. |
| Publisher Information: |
CCSD; Oxford University Press (OUP) |
| Publication Year: |
2024 |
| Collection: |
LillOA (HAL Lille Open Archive, Université de Lille) |
| Subject Terms: |
systemic sclerosis; interstitial lung disease; early treatment; [SDV]Life Sciences [q-bio] |
| Description: |
International audience ; BackgroundHypothesizing that early treatment yields improved prognosis, we aimed to investigate how the timing of immunosuppressive treatment relates to interstitial lung disease (ILD) development and the course of pulmonary function in systemic sclerosis (SSc).MethodsA cohort was created using data from the EUSTAR database and Nijmegen Systemic Sclerosis cohort, including adult patients who started their first immunosuppressive treatment (i.e. mycophenolate mofetil, methotrexate, cyclophosphamide, tocilizumab or rituximab) after SSc diagnosis, and no signs of ILD on high-resolution CT. ILD-free survival and the course of forced vital capacity (FVC) % predicted were assessed for up to 5 years’ follow-up comparing patients who started early (disease duration ≤3 years) vs late with immunosuppression.Results1052 patients met the eligibility criteria. The early treatment group (n = 547, 52%) showed a higher prevalence of male sex, diffuse cutaneous subtype (53.1% vs 36.5%), and anti-topoisomerase-I antibody (ATA, 51.1% vs 42.7%). Most patients were treated with methotrexate (60.1%), whereas only a few patients were treated with biologics (1.7%). The incidence of ILD was 46.6% after mean (s.d.) 3.6 (1.4) years; the hazards ratio for ILD in the early treatment group was 1.13 (95% CI: 0.93, 1.38) after adjustment for confounders. FVC % predicted trajectories were comparable between groups.ConclusionOur findings did not confirm a preventive role of early initiation of immunosuppressive therapy vs late initiation on ILD development. However, our findings should be interpreted with caution, considering the high inflammatory, ATA-positive enriched nature of the cohort, confounding by indication, and that very few patients were treated with biologics. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/39037917; PUBMED: 39037917 |
| DOI: |
10.1093/rheumatology/keae375 |
| Availability: |
https://hal.univ-lille.fr/hal-04686859; https://hal.univ-lille.fr/hal-04686859v1/document; https://hal.univ-lille.fr/hal-04686859v1/file/keae375.pdf; https://doi.org/10.1093/rheumatology/keae375 |
| Rights: |
info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.9749635 |
| Database: |
BASE |