Evidence map›Paper›PMID 39702378›Full record

ArticleArthritis research & therapy2024

Poor prognostic factors for relapse of interstitial lung disease in microscopic polyangiitis: the Japanese multicentre REVEAL cohort study.

Shogo Matsuda, Takuya Kotani, Ayana Okazaki, Daisuke Nishioka, Yuichi Masuda, Mayu Shiomi, Ryu Watanabe, Tomoki Taniguchi, Atsushi Manabe, Keiichiro Kadoba and 5 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Arthritis research & therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

15 authors.

Shogo MatsudaDepartment of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan.
Takuya KotaniDepartment of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan. takuya.kotani@ompu.ac.jp.
Ayana OkazakiDepartment of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan.
Daisuke NishiokaDepartment of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Yuichi MasudaDepartment of Internal Medicine IV, Division of Neurology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Mayu ShiomiDepartment of Clinical Immunology, Osaka Metropolitan University, Osaka, Japan.
Ryu WatanabeDepartment of Clinical Immunology, Osaka Metropolitan University, Osaka, Japan.
Tomoki TaniguchiDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Atsushi ManabeDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Keiichiro KadobaDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Tsuneyasu YoshidaDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Ryosuke HiwaDepartment of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Wataru YamamotoDepartment of Health Information Management, Kurashiki Sweet Hospital, Kurashiki, Japan.
Motomu HashimotoDepartment of Clinical Immunology, Osaka Metropolitan University, Osaka, Japan.
Tohru TakeuchiDepartment of Internal Medicine IV, Division of Rheumatology, Osaka Medical and Pharmaceutical University, Daigaku-Machi 2-7, Takatsuki, Osaka, 569-8686, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study investigated poor prognostic factors for the relapse of interstitial lung disease (ILD) in patients with microscopic polyangiitis (MPA) after remission induction therapy.

methodsWe enrolled patients diagnosed with MPA complicated by ILD according to the Chapel Hill Consensus definition from 2001 to 2023 in multiple institutions in the REVEAL cohort. All patients who were treated with immunosuppressive therapy were followed up, and those who relapsed with ILD were extracted in this study. We explored the risk factors for predicting ILD relapse in patients with MPA-ILD by comparing the demographic, clinical, laboratory, and radiological findings and treatments between the relapsed and non-relapsed groups on admission.

resultsOf 243 patients with MPA, 134 (55.1%) with MPA-ILD were enrolled. Among them, 28 (20.9%) relapsed during a mean follow-up of 4.2 years. The initial serum Krebs von den Lungen-6 (KL-6) and surfactant protein-D (SP-D) levels and the prevalence of usual interstitial pneumonia (UIP) pattern were significantly higher in the relapsed group. The biomarkers were also risk factors for relapse in multivariate Cox regression analysis. The best cut-off values of KL-6, SP-D for predicting ILD relapse were 430 U/mL and 89.5 ng/mL, respectively. We created prediction models based on the best cut-off values for KL-6, SP-D, and the presence of the UIP pattern (KSU model). The 10-year relapse rate was significantly different among patients with MPA-ILD stratified by the number of risk factors based on the KSU model. A higher relapse rate was associated with higher all-cause mortality.

conclusionsThe initial serum high KL-6 and SP-D levels and the prevalence of the UIP pattern were associated with ILD relapse in patients with MPA-ILD. Our multicentre cohort study indicated that the KSU model, which consists of KL-6 ≥ 430 U/mL, SP-D ≥ 89.5 ng/mL, and the presence of the UIP pattern, is a useful predictor of ILD relapse in patients with MPA after immunosuppressive therapy.

Indexed as

Lung Diseases, InterstitialMicroscopic PolyangiitisRecurrenceAdultAgedBiomarkersCohort StudiesEast Asian PeopleFemaleHumansImmunosuppressive AgentsJapanMaleMiddle AgedMucin-1PrognosisBiomarkersImmunosuppressive AgentsMUC1 protein, humanMucin-1Pulmonary Surfactant-Associated Protein DHigh-resolution computed tomography scoringInterstitial lung diseaseMicroscopic polyangiitisPrediction modelsRelapse

Identifiers

PMID39702378
PMCPMC11656796

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