Pulmonary infections following immunosuppressive treatments during hospitalization worsen the short-term vital prognosis for patients with connective tissue disease-associated interstitial pneumonia

Michi Tanaka, Ryuji Koike, Ryoko Sakai, Kazuyoshi Saito, Shintaro Hirata, Hayato Nagasawa, Hideto Kameda, Masako Hara, Yasushi Kawaguchi, Shigeto Tohma, Yoshinari Takasaki, Makoto Dohi, Yasuhiko Nishioka, Shinsuke Yasuda, Yasunari Miyazaki, Yuko Kaneko, Toshihiro Nanki, Kaori Watanabe, Hayato Yamazaki, Nobuyuki MiyasakaMasayoshi Harigai

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)609-614
Number of pages6
JournalModern Rheumatology
Volume25
Issue number4
DOIs
Publication statusPublished - 2015

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Connective Tissue Diseases
Interstitial Lung Diseases
Immunosuppressive Agents
Hospitalization
Lung
Infection
Therapeutics
Microscopic Polyangiitis
Mixed Connective Tissue Disease
Polymyositis
Dermatomyositis
Systemic Scleroderma
Proportional Hazards Models
Systemic Lupus Erythematosus
Multicenter Studies
Rheumatoid Arthritis
Retrospective Studies
Mortality

Keywords

  • Connective tissue disease
  • Immunosuppressive treatments
  • Interstitial pneumonia
  • Pulmonary infections
  • Vital prognosis

ASJC Scopus subject areas

  • Rheumatology

Cite this

Pulmonary infections following immunosuppressive treatments during hospitalization worsen the short-term vital prognosis for patients with connective tissue disease-associated interstitial pneumonia. / Tanaka, Michi; Koike, Ryuji; Sakai, Ryoko; Saito, Kazuyoshi; Hirata, Shintaro; Nagasawa, Hayato; Kameda, Hideto; Hara, Masako; Kawaguchi, Yasushi; Tohma, Shigeto; Takasaki, Yoshinari; Dohi, Makoto; Nishioka, Yasuhiko; Yasuda, Shinsuke; Miyazaki, Yasunari; Kaneko, Yuko; Nanki, Toshihiro; Watanabe, Kaori; Yamazaki, Hayato; Miyasaka, Nobuyuki; Harigai, Masayoshi.

In: Modern Rheumatology, Vol. 25, No. 4, 2015, p. 609-614.

Research output: Contribution to journalArticle

Tanaka, M, Koike, R, Sakai, R, Saito, K, Hirata, S, Nagasawa, H, Kameda, H, Hara, M, Kawaguchi, Y, Tohma, S, Takasaki, Y, Dohi, M, Nishioka, Y, Yasuda, S, Miyazaki, Y, Kaneko, Y, Nanki, T, Watanabe, K, Yamazaki, H, Miyasaka, N & Harigai, M 2015, 'Pulmonary infections following immunosuppressive treatments during hospitalization worsen the short-term vital prognosis for patients with connective tissue disease-associated interstitial pneumonia', Modern Rheumatology, vol. 25, no. 4, pp. 609-614. https://doi.org/10.3109/14397595.2014.980384
Tanaka, Michi ; Koike, Ryuji ; Sakai, Ryoko ; Saito, Kazuyoshi ; Hirata, Shintaro ; Nagasawa, Hayato ; Kameda, Hideto ; Hara, Masako ; Kawaguchi, Yasushi ; Tohma, Shigeto ; Takasaki, Yoshinari ; Dohi, Makoto ; Nishioka, Yasuhiko ; Yasuda, Shinsuke ; Miyazaki, Yasunari ; Kaneko, Yuko ; Nanki, Toshihiro ; Watanabe, Kaori ; Yamazaki, Hayato ; Miyasaka, Nobuyuki ; Harigai, Masayoshi. / Pulmonary infections following immunosuppressive treatments during hospitalization worsen the short-term vital prognosis for patients with connective tissue disease-associated interstitial pneumonia. In: Modern Rheumatology. 2015 ; Vol. 25, No. 4. pp. 609-614.
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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

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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