TY - JOUR
T1 - Pulmonary infections following immunosuppressive treatments during hospitalization worsen the short-term vital prognosis for patients with connective tissue disease-associated interstitial pneumonia
AU - Tanaka, Michi
AU - Koike, Ryuji
AU - Sakai, Ryoko
AU - Saito, Kazuyoshi
AU - Hirata, Shintaro
AU - Nagasawa, Hayato
AU - Kameda, Hideto
AU - Hara, Masako
AU - Kawaguchi, Yasushi
AU - Tohma, Shigeto
AU - Takasaki, Yoshinari
AU - Dohi, Makoto
AU - Nishioka, Yasuhiko
AU - Yasuda, Shinsuke
AU - Miyazaki, Yasunari
AU - Kaneko, Yuko
AU - Nanki, Toshihiro
AU - Watanabe, Kaori
AU - Yamazaki, Hayato
AU - Miyasaka, Nobuyuki
AU - Harigai, Masayoshi
N1 - Funding Information:
This work was supported by a grant-in-aid from the Ministry of Health, Labour and Welfare, Japan (H23-meneki-sitei-016 and H19-meneki-ippan-009 to N. Miyasaka, H22-meneki-ippann-001 to M. Harigai) and by a grant-in-aid for scientific research from the Japan Society for the Promotion of Science (#20390158 to M. Harigai, #19590530 to R. Koike, and #50277141 to M. Tanaka). This work was also supported by the grant from the Japanese Ministry of Education, Global Center of Excellence (GCOE) Program, “ International Research Center for Molecular Science in Tooth and Bone Diseases ” (to N. Miyasaka).
Publisher Copyright:
© 2014 Japan College of Rheumatology
PY - 2015
Y1 - 2015
N2 - Objective. Connective tissue disease-associated interstitial pneumonia (CTD-IP) significantly affects the mortality of patients with CTD. The purpose of the present study is to identify causes and risk factors for death during hospitalization for immunosuppressive treatment of CTD-IP. Methods. A multicenter, retrospective study was conducted that collected data from patients with CTD who had been hospitalized for commencing or intensifying immunosuppressive treatment of CTD-IP using a standardized case report form. Risk factors were identified using the Cox proportional hazard regression model. Results. A total of 322 CTD-IP patients were enrolled with rheumatoid arthritis (n = 84), systemic lupus erythematosus (n = 13), polymyositis (n = 33), dermatomyositis (n = 69), systemic sclerosis (n = 55), mixed connective tissue disease (n = 21), microscopic polyangiitis (n = 19), and overlap syndrome (n = 28). Of the 42patients who died during hospitalization, 22 died from CTD-IP, 15 from CTD-IP and pulmonary infection, 2 from pulmonary infection, and 3 from other causes. Age > 65 years and development of pulmonary infections after commencing or intensifying immunosuppressive treatments were identified as risk factors for death during hospitalization after adjusting for covariates. Conclusion. Careful consideration of the benefit - risk balance of immunosuppressive treatment for CTD-IP is indispensable for improving the short-term vital prognosis of these patients.
AB - Objective. Connective tissue disease-associated interstitial pneumonia (CTD-IP) significantly affects the mortality of patients with CTD. The purpose of the present study is to identify causes and risk factors for death during hospitalization for immunosuppressive treatment of CTD-IP. Methods. A multicenter, retrospective study was conducted that collected data from patients with CTD who had been hospitalized for commencing or intensifying immunosuppressive treatment of CTD-IP using a standardized case report form. Risk factors were identified using the Cox proportional hazard regression model. Results. A total of 322 CTD-IP patients were enrolled with rheumatoid arthritis (n = 84), systemic lupus erythematosus (n = 13), polymyositis (n = 33), dermatomyositis (n = 69), systemic sclerosis (n = 55), mixed connective tissue disease (n = 21), microscopic polyangiitis (n = 19), and overlap syndrome (n = 28). Of the 42patients who died during hospitalization, 22 died from CTD-IP, 15 from CTD-IP and pulmonary infection, 2 from pulmonary infection, and 3 from other causes. Age > 65 years and development of pulmonary infections after commencing or intensifying immunosuppressive treatments were identified as risk factors for death during hospitalization after adjusting for covariates. Conclusion. Careful consideration of the benefit - risk balance of immunosuppressive treatment for CTD-IP is indispensable for improving the short-term vital prognosis of these patients.
KW - Connective tissue disease
KW - Immunosuppressive treatments
KW - Interstitial pneumonia
KW - Pulmonary infections
KW - Vital prognosis
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U2 - 10.3109/14397595.2014.980384
DO - 10.3109/14397595.2014.980384
M3 - Article
C2 - 25496409
AN - SCOPUS:84935016185
VL - 25
SP - 609
EP - 614
JO - Japanese Journal of Rheumatology
JF - Japanese Journal of Rheumatology
SN - 1439-7595
IS - 4
ER -