scholarly journals Methotrexate and rheumatoid arthritis associated interstitial lung disease

2020 ◽  
pp. 2000337
Author(s):  
Pierre-Antoine Juge ◽  
Joyce S. Lee ◽  
Jessica Lau ◽  
Leticia Kawano-Dourado ◽  
Jorge Rojas Serrano ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Case Control Study ◽  
Meta Analysis ◽  
High Resolution Computed Tomography ◽  
Analysis Techniques ◽  
Discovery Sample ◽  
Increased Risk ◽  
Control Study

Question addressed by the studyMethotrexate (MTX) is a key anchor drug for rheumatoid arthritis (RA) management. Fibrotic interstitial lung disease (ILD) is a common complication of RA. Whether MTX exposure increases the risk of ILD in patients with RA is disputed. We aimed to evaluate the association of prior MTX use with development of RA-ILD.MethodsThrough a case-control study design with discovery and international replication samples, we examined the association of MTX exposure with ILD in 410 patients with chronic fibrotic ILD associated with RA (RA-ILD) and 673 patients with RA without ILD. Estimates were pooled over the different samples using meta-analysis techniques.ResultsAnalysis of the discovery sample revealed an inverse relationship between MTX exposure and RA-ILD (adjusted odds ratio [OR], 0.46; 95% confidence interval [CI], 0.24–0.90; p=0.022), which was confirmed in the replication samples (pooled adjusted OR, 0.39; 95% CI, 0.19–0.79; p=0.009). The combined estimate using both the derivation and validation samples revealed an adjusted OR of 0.43 (95% CI, 0.26–0.69; p=0.0006). MTX ever users were less frequent among patients with RA-ILD compared to those without ILD, irrespective of chest high resolution computed tomography pattern. In patients with RA-ILD, ILD detection was significantly delayed in MTX ever users compared to never users (11.4±10.4 years and 4.0±7.4 years, respectively; p<0.001).Answer to the QuestionOur results suggest that MTX use is not associated with an increased risk of RA-ILD in patients with RA, and that ILD was detected later in MTX treated patients.

scholarly journals Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease

2015 ◽  
Vol 47 (2) ◽  
pp. 588-596 ◽  
Author(s):  
Joshua J. Solomon ◽  
Jonathan H. Chung ◽  
Gregory P. Cosgrove ◽  
M. Kristen Demoruelle ◽  
Evans R. Fernandez-Perez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
High Resolution Computed Tomography ◽  
Predictors Of Mortality ◽  
Risk Of Death ◽  
Increased Risk ◽  
Over Time

Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis. There is lack of clarity around predictors of mortality and disease behaviour over time in these patients.We identified rheumatoid arthritis-related interstitial lung disease (RA-ILD) patients evaluated at National Jewish Health (Denver, CO, USA) from 1995 to 2013 whose baseline high-resolution computed tomography (HRCT) scans showed either a nonspecific interstitial pneumonia (NSIP) or a “definite” or “possible” usual interstitial pneumonia (UIP) pattern. We used univariate, multivariate and longitudinal analytical methods to identify clinical predictors of mortality and to model disease behaviour over time.The cohort included 137 subjects; 108 had UIP on HRCT (RA-UIP) and 29 had NSIP on HRCT (RA-NSIP). Those with RA-UIP had a shorter survival time than those with RA-NSIP (log rank p=0.02). In a model controlling for age, sex, smoking and HRCT pattern, a lower baseline % predicted forced vital capacity (FVC % pred) (HR 1.46; p<0.0001) and a 10% decline in FVC % pred from baseline to any time during follow up (HR 2.57; p<0.0001) were independently associated with an increased risk of death.Data from this study suggest that in RA-ILD, disease progression and survival differ between subgroups defined by HRCT pattern; however, when controlling for potentially influential variables, pulmonary physiology, but not HRCT pattern, independently predicts mortality.

scholarly journals Interstitial Lung Disease Associated with Lung Cancer: A Case–Control Study

2020 ◽  
Vol 9 (3) ◽  
pp. 700
Author(s):  
Quentin Gibiot ◽  
Isabelle Monnet ◽  
Pierre Levy ◽  
Anne-Laure Brun ◽  
Martine Antoine ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Case Control Study ◽  
Standard Of Care ◽  
Case Control ◽  
Risk Of Death ◽  
Increased Risk ◽  
Two Factors ◽  
Control Study

Interstitial lung disease (ILD) seems to be associated with an increased risk of lung cancer (LC) and to have a poorer prognosis than LC without ILD. The frequency of ILD in an LC cohort and its prognosis implication need to be better elucidated. This retrospective, observational, cohort study evaluated the frequency of ILD among LC patients (LC–ILD) diagnosed over a 2-year period. LC–ILD patients’ characteristics were compared to those with LC without ILD (LC–noILD). Lastly, we conducted a case–control study within this cohort, matching three LC–noILDs to each LC–ILD patient, to evaluate the ILD impact on LC patients’ prognoses. Among 906 LC patients, 49 (5.4%) also had ILD. Comparing LC–ILD to LC–noILD patients, respectively, more were men (85.7% vs. 66.2%; p = 0.02); adenocarcinomas were less frequent (47.1% vs. 58.7%, p = 0.08); median [range] and overall survival was shorter: (9 [range: 0.1–39.4] vs. 17.5 [range: 0.8–50.4] months; p = 0.01). Multivariate analysis (hazard ratio [95% confidence interval]) retained two factors independently associated with LC risk of death: ILD (1.79 [1.22–2.62]; p = 0.003) and standard-of-care management (0.49 [0.33–0.72]; p < 0.001). Approximately 5% of patients with a new LC diagnosis had associated ILD. ILD was a major prognosis factor for LC and should be taken into consideration for LC management. Further studies are needed to determine the best therapeutic strategy for the LC–ILD population.

Decreased peripheral blood memory B cells are associated with the presence of interstitial lung disease in rheumatoid arthritis: a case-control study

2020 ◽  
Vol 31 (1) ◽  
pp. 127-132 ◽  
Author(s):  
Toshiaki Shimizu ◽  
Yasuo Nagafuchi ◽  
Hiroaki Harada ◽  
Yumi Tsuchida ◽  
Haruka Tsuchiya ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
B Cells ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Peripheral Blood ◽  
Case Control Study ◽  
Case Control ◽  
Memory B Cells ◽  
Control Study

scholarly journals Acute exacerbation in rheumatoid arthritis-associated interstitial lung disease: a retrospective case control study

BMJ Open ◽  
2013 ◽  
Vol 3 (9) ◽  
pp. e003132 ◽  
Author(s):  
Hironao Hozumi ◽  
Yutaro Nakamura ◽  
Takeshi Johkoh ◽  
Hiromitsu Sumikawa ◽  
Thomas V Colby ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Acute Exacerbation ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Control Study

scholarly journals Increased Odds of Death for Patients with Interstitial Lung Disease and COVID-19: A Case–Control Study

2020 ◽  
Vol 202 (12) ◽  
pp. 1710-1713 ◽  
Author(s):  
Anthony J. Esposito ◽  
Aravind A. Menon ◽  
Auyon J. Ghosh ◽  
Rachel K. Putman ◽  
Laura E. Fredenburgh ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Case Control Study ◽  
Case Control ◽  
Control Study
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