Sabrina Hoa1,2, Sasha Bernatsky1,3,4, Russell J Steele2,5, Murray Baron2,3,6, Marie Hudson2,3,6. 1. Department of Epidemiology, Biostatistics and Occupational Health, McGill University. 2. Lady Davis Institute, Jewish General Hospital. 3. Department of Medicine, McGill University. 4. Research Institute of the McGill University Health Centre. 5. Department of Mathematics and Statistics, McGill University. 6. Division of Rheumatology, Jewish General Hospital, Montreal, Quebec, Canada.
Abstract
OBJECTIVE: Interstitial lung disease (ILD) is a leading cause of mortality in SSc. Little is known about the benefits of immunosuppressive drugs in mild ILD. Our aim was to determine whether use of CYC or MMF was associated with an improved ILD course in patients with normal or mildly impaired lung function. METHODS: A retrospective cohort of SSc subjects with ILD, disease duration below seven years and no exposure to CYC or MMF prior to the baseline visit was constructed from the Canadian Scleroderma Research Group registry. Subjects were categorized as having mild ILD if baseline forced vital capacity (FVC % predicted) was >85%. The primary exposure was any use of CYC or MMF at the baseline visit. FVC at one year was compared between exposed and unexposed subjects, using multivariate linear regression. RESULTS: Out of 294 eligible SSc-ILD subjects, 116 met criteria for mild ILD. In this subgroup, mean (s.d.) disease duration was 3.7 (2.0) years. Thirteen (11.2%) subjects were exposed to CYC or MMF at baseline. The one-year FVC was higher in exposed subjects compared with unexposed subjects, by a difference of 8.49% (95% CI: 0.01-16.98%). None of the exposed subjects experienced clinically meaningful progression over two years, whereas 24.6% of unexposed subjects did. CONCLUSION: In this real-world setting, CYC/MMF exposure at baseline was associated with higher FVC values and a lower risk of progression among subjects with mild ILD. These data suggest a window of opportunity to preserve lung function in SSc-ILD.
OBJECTIVE:Interstitial lung disease (ILD) is a leading cause of mortality in SSc. Little is known about the benefits of immunosuppressive drugs in mild ILD. Our aim was to determine whether use of CYC or MMF was associated with an improved ILD course in patients with normal or mildly impaired lung function. METHODS: A retrospective cohort of SSc subjects with ILD, disease duration below seven years and no exposure to CYC or MMF prior to the baseline visit was constructed from the Canadian Scleroderma Research Group registry. Subjects were categorized as having mild ILD if baseline forced vital capacity (FVC % predicted) was >85%. The primary exposure was any use of CYC or MMF at the baseline visit. FVC at one year was compared between exposed and unexposed subjects, using multivariate linear regression. RESULTS: Out of 294 eligible SSc-ILD subjects, 116 met criteria for mild ILD. In this subgroup, mean (s.d.) disease duration was 3.7 (2.0) years. Thirteen (11.2%) subjects were exposed to CYC or MMF at baseline. The one-year FVC was higher in exposed subjects compared with unexposed subjects, by a difference of 8.49% (95% CI: 0.01-16.98%). None of the exposed subjects experienced clinically meaningful progression over two years, whereas 24.6% of unexposed subjects did. CONCLUSION: In this real-world setting, CYC/MMF exposure at baseline was associated with higher FVC values and a lower risk of progression among subjects with mild ILD. These data suggest a window of opportunity to preserve lung function in SSc-ILD.
Authors: Nicole S Goh; Rachel K Hoyles; Christopher P Denton; David M Hansell; Elisabetta A Renzoni; Toby M Maher; Andrew G Nicholson; Athol U Wells Journal: Arthritis Rheumatol Date: 2017-07-18 Impact factor: 10.995
Authors: Dinesh Khanna; Chi-Hong Tseng; Niloofar Farmani; Virginia Steen; Daniel E Furst; Philip J Clements; Michael D Roth; Jonathan Goldin; Robert Elashoff; James R Seibold; Rajeev Saggar; Donald P Tashkin Journal: Arthritis Rheum Date: 2011-10
Authors: Donald P Tashkin; Elizabeth R Volkmann; Chi-Hong Tseng; Hyun J Kim; Jonathan Goldin; Philip Clements; Daniel Furst; Dinesh Khanna; Eric Kleerup; Michael D Roth; Robert Elashoff Journal: Ann Rheum Dis Date: 2014-12-01 Impact factor: 19.103
Authors: Rachel K Hoyles; Ross W Ellis; Jessica Wellsbury; Belinda Lees; Pauline Newlands; Nicole S L Goh; Christopher Roberts; Sujal Desai; Ariane L Herrick; Neil J McHugh; Noeleen M Foley; Stanley B Pearson; Paul Emery; Douglas J Veale; Christopher P Denton; Athol U Wells; Carol M Black; Roland M du Bois Journal: Arthritis Rheum Date: 2006-12
Authors: Nicole S L Goh; Sujal R Desai; Srihari Veeraraghavan; David M Hansell; Susan J Copley; Toby M Maher; Tamera J Corte; Clare R Sander; Jonathan Ratoff; Anand Devaraj; Gracijela Bozovic; Christopher P Denton; Carol M Black; Roland M du Bois; Athol U Wells Journal: Am J Respir Crit Care Med Date: 2008-03-27 Impact factor: 21.405
Authors: W M T van den Hombergh; S O Simons; E Teesselink; H K A Knaapen-Hans; F H J van den Hoogen; J Fransen; M C Vonk Journal: Clin Rheumatol Date: 2018-07-10 Impact factor: 2.980
Authors: Vivek Nagaraja; Marco Matucci-Cerinic; Daniel E Furst; Masataka Kuwana; Yannick Allanore; Christopher P Denton; Ganesh Raghu; Vallerie Mclaughlin; Panduranga S Rao; James R Seibold; John D Pauling; Michael L Whitfield; Dinesh Khanna Journal: Arthritis Rheumatol Date: 2020-05-18 Impact factor: 10.995
Authors: Justin K Lui; Ruchika A Sangani; Clara A Chen; Andreea M Bujor; Marcin A Trojanowski; Deepa M Gopal; Michael P LaValley; Renda Soylemez Wiener; Elizabeth S Klings Journal: Arthritis Care Res (Hoboken) Date: 2022-04-05 Impact factor: 5.178
Authors: Ruchika A Sangani; Justin K Lui; Kari R Gillmeyer; Marcin A Trojanowski; Andreea M Bujor; Michael P LaValley; Elizabeth S Klings Journal: Pulm Circ Date: 2022-10-01 Impact factor: 2.886
Authors: Anastasiya Muntyanu; Raymond Milan; Elham Rahme; Avery LaChance; Lydia Ouchene; Maxime Cormier; Ivan V Litvinov; Marie Hudson; Murray Baron; Elena Netchiporouk Journal: Front Med (Lausanne) Date: 2022-09-29