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Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis
OBJECTIVE: Biological disease-modifying anti-rheumatic drugs (bDMARDs) represent an important advance in alleviating rheumatoid arthritis (RA), but their effect on rheumatic airway disease (AD) and interstitial lung disease (ILD) is still unclear. This study was performed to evaluate the association...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japanese Society of Internal Medicine
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630137/ https://www.ncbi.nlm.nih.gov/pubmed/30799358 http://dx.doi.org/10.2169/internalmedicine.2226-18 |
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author | Kurata, Izumi Tsuboi, Hiroto Terasaki, Mayu Shimizu, Masaru Toko, Hirofumi Honda, Fumika Ohyama, Ayako Yagishita, Mizuki Osada, Atsumu Ebe, Hiroshi Kawaguchi, Hoshimi Takahashi, Hiroyuki Hagiwara, Shinya Asashima, Hiromitsu Kondo, Yuya Matsumoto, Isao Sumida, Takayuki |
author_facet | Kurata, Izumi Tsuboi, Hiroto Terasaki, Mayu Shimizu, Masaru Toko, Hirofumi Honda, Fumika Ohyama, Ayako Yagishita, Mizuki Osada, Atsumu Ebe, Hiroshi Kawaguchi, Hoshimi Takahashi, Hiroyuki Hagiwara, Shinya Asashima, Hiromitsu Kondo, Yuya Matsumoto, Isao Sumida, Takayuki |
author_sort | Kurata, Izumi |
collection | PubMed |
description | OBJECTIVE: Biological disease-modifying anti-rheumatic drugs (bDMARDs) represent an important advance in alleviating rheumatoid arthritis (RA), but their effect on rheumatic airway disease (AD) and interstitial lung disease (ILD) is still unclear. This study was performed to evaluate the association of the use of different bDMARDs with new-onset or worsening of RA-AD/ILD. METHODS: We performed a retrospective cohort study of RA patients who received bDMARDs and assessed their AD/ILD before and after drug initiation in our hospital over the past 10 years. We evaluated the serial changes in computed tomography (CT), classified patients according to AD/ILD progression, and analyzed associations between clinical characteristics and outcomes. RESULTS: We enrolled 49 patients. Thirty patients received tumor necrosis factor inhibitors (TNFis), 12 received abatacept (ABT), and the remaining 7 received tocilizumab (TCZ). Seventeen patients had ILD, 10 had AD, and 6 had both AD and ILD before the initiation of bDMARDs. New emergence or exacerbation of AD/ILD was observed in 18 patients after drug initiation, while the remaining 31 remained stable or improved. Multiple logistic regression analyses revealed that pre-existing AD was an independent risk factor against the emergence or exacerbation of RA-AD/ILD, and ABT use was a protective factor against it. CONCLUSION: Our study showed that pre-existing RA-AD is associated with future worsening of RA-AD/ILD, and ABT over other bDMARDs was associated with a better prognosis. Future studies to confirm our results are needed. |
format | Online Article Text |
id | pubmed-6630137 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | The Japanese Society of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-66301372019-07-17 Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis Kurata, Izumi Tsuboi, Hiroto Terasaki, Mayu Shimizu, Masaru Toko, Hirofumi Honda, Fumika Ohyama, Ayako Yagishita, Mizuki Osada, Atsumu Ebe, Hiroshi Kawaguchi, Hoshimi Takahashi, Hiroyuki Hagiwara, Shinya Asashima, Hiromitsu Kondo, Yuya Matsumoto, Isao Sumida, Takayuki Intern Med Original Article OBJECTIVE: Biological disease-modifying anti-rheumatic drugs (bDMARDs) represent an important advance in alleviating rheumatoid arthritis (RA), but their effect on rheumatic airway disease (AD) and interstitial lung disease (ILD) is still unclear. This study was performed to evaluate the association of the use of different bDMARDs with new-onset or worsening of RA-AD/ILD. METHODS: We performed a retrospective cohort study of RA patients who received bDMARDs and assessed their AD/ILD before and after drug initiation in our hospital over the past 10 years. We evaluated the serial changes in computed tomography (CT), classified patients according to AD/ILD progression, and analyzed associations between clinical characteristics and outcomes. RESULTS: We enrolled 49 patients. Thirty patients received tumor necrosis factor inhibitors (TNFis), 12 received abatacept (ABT), and the remaining 7 received tocilizumab (TCZ). Seventeen patients had ILD, 10 had AD, and 6 had both AD and ILD before the initiation of bDMARDs. New emergence or exacerbation of AD/ILD was observed in 18 patients after drug initiation, while the remaining 31 remained stable or improved. Multiple logistic regression analyses revealed that pre-existing AD was an independent risk factor against the emergence or exacerbation of RA-AD/ILD, and ABT use was a protective factor against it. CONCLUSION: Our study showed that pre-existing RA-AD is associated with future worsening of RA-AD/ILD, and ABT over other bDMARDs was associated with a better prognosis. Future studies to confirm our results are needed. The Japanese Society of Internal Medicine 2019-02-25 2019-06-15 /pmc/articles/PMC6630137/ /pubmed/30799358 http://dx.doi.org/10.2169/internalmedicine.2226-18 Text en Copyright © 2019 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Kurata, Izumi Tsuboi, Hiroto Terasaki, Mayu Shimizu, Masaru Toko, Hirofumi Honda, Fumika Ohyama, Ayako Yagishita, Mizuki Osada, Atsumu Ebe, Hiroshi Kawaguchi, Hoshimi Takahashi, Hiroyuki Hagiwara, Shinya Asashima, Hiromitsu Kondo, Yuya Matsumoto, Isao Sumida, Takayuki Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis |
title | Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis |
title_full | Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis |
title_fullStr | Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis |
title_full_unstemmed | Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis |
title_short | Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis |
title_sort | effect of biological disease-modifying anti-rheumatic drugs on airway and interstitial lung disease in patients with rheumatoid arthritis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630137/ https://www.ncbi.nlm.nih.gov/pubmed/30799358 http://dx.doi.org/10.2169/internalmedicine.2226-18 |
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