Methotrexate, leflunomide and tacrolimus use and the progression of rheumatoid arthritis-associated interstitial lung disease
- Authors
- Kim, Ji-Won; Chung, Sang Wan; Pyo, Jung Yoon; Chang, Sung Hae; Kim, Min Uk; Park, Chan Ho; Lee, Ji Sung; Lee, Jeong Seok; Ha, You-Jung; Kang, Eun Ha; Lee, Yeon-Ah; Park, Yong-Beom; Lee, Eun Young; Choe, Jung-Yoon
- Issue Date
- Nov-2022
- Publisher
- Oxford University Press
- Keywords
- RA; interstitial lung disease; MTX; LEF; tacrolimus; progression-free survival
- Citation
- Rheumatology, v.62, no.7, pp 2377 - 2385
- Pages
- 9
- Journal Title
- Rheumatology
- Volume
- 62
- Number
- 7
- Start Page
- 2377
- End Page
- 2385
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/22089
- DOI
- 10.1093/rheumatology/keac651
- ISSN
- 1462-0324
1462-0332
- Abstract
- Objective To examine the association between MTX, LEF and tacrolimus use and the progression of RA-associated interstitial lung disease (ILD). Methods The Korean RA-ILD cohort prospectively enrolled patients with RA-associated ILD at multiple centres from 2015 to 2018 and followed up with them for 3 years. ILD progression was defined by any of the followings: a decrease of >= 10% in forced vital capacity, a decrease of >= 15% in the diffusing capacity of the lung for carbon monoxide, or death from respiratory failure. Results Of 143 patients, 64 patients experienced ILD progression during a median follow-up period of 33 months. The use of MTX [adjusted hazard ratio (aHR), 1.06; 95% CI, 0.59, 1.89], LEF (aHR, 1.75; 95% CI, 0.88, 3.46) and tacrolimus (aHR, 0.94; 95% CI, 0.52, 1.72) did not increase the risk of ILD progression. However, the association between LEF use and the risk of ILD progression was significant in subgroups with poor lung function (aHR, 8.42; 95% CI, 2.61, 27.15). Older age, male sex, a shorter RA duration, higher RA disease activity and extensive disease at baseline were independently associated with ILD progression. Conclusion None of the three treatments increased the risk of RA-associated ILD progression, except for LEF, which increased the risk of ILD progression in patients with severe ILD. The appropriate use of conventional synthetic disease-modifying antirheumatic drugs considering RA disease activity and ILD severity would be important for the management of RA-associated ILD.
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Collections - College of Medicine > Department of Radiology > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
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