Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis

Abstract Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive...

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Autores principales:	Esteban Cano-Jiménez, Tomás Vázquez Rodríguez, Irene Martín-Robles, Diego Castillo Villegas, Javier Juan García, Elena Bollo de Miguel, Alejandro Robles-Pérez, Marta Ferrer Galván, Cecilia Mouronte Roibas, Susana Herrera Lara, Guadalupe Bermudo, Marta García Moyano, Jose Antonio Rodríguez Portal, Jacobo Sellarés Torres, Javier Narváez, María Molina-Molina
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e334e345eec5491a94d1f3b8b69e06c5
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spelling	oai:doaj.org-article:e334e345eec5491a94d1f3b8b69e06c52021-12-02T13:41:00ZDiagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis10.1038/s41598-021-88734-22045-2322https://doaj.org/article/e334e345eec5491a94d1f3b8b69e06c52021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-88734-2https://doaj.org/toc/2045-2322Abstract Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01–1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09–1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73–0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39–0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59–13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03–1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14–4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.Esteban Cano-JiménezTomás Vázquez RodríguezIrene Martín-RoblesDiego Castillo VillegasJavier Juan GarcíaElena Bollo de MiguelAlejandro Robles-PérezMarta Ferrer GalvánCecilia Mouronte RoibasSusana Herrera LaraGuadalupe BermudoMarta García MoyanoJose Antonio Rodríguez PortalJacobo Sellarés TorresJavier NarváezMaría Molina-MolinaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Esteban Cano-Jiménez Tomás Vázquez Rodríguez Irene Martín-Robles Diego Castillo Villegas Javier Juan García Elena Bollo de Miguel Alejandro Robles-Pérez Marta Ferrer Galván Cecilia Mouronte Roibas Susana Herrera Lara Guadalupe Bermudo Marta García Moyano Jose Antonio Rodríguez Portal Jacobo Sellarés Torres Javier Narváez María Molina-Molina Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
description	Abstract Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01–1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09–1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73–0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39–0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59–13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03–1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14–4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.
format	article
author	Esteban Cano-Jiménez Tomás Vázquez Rodríguez Irene Martín-Robles Diego Castillo Villegas Javier Juan García Elena Bollo de Miguel Alejandro Robles-Pérez Marta Ferrer Galván Cecilia Mouronte Roibas Susana Herrera Lara Guadalupe Bermudo Marta García Moyano Jose Antonio Rodríguez Portal Jacobo Sellarés Torres Javier Narváez María Molina-Molina
author_facet	Esteban Cano-Jiménez Tomás Vázquez Rodríguez Irene Martín-Robles Diego Castillo Villegas Javier Juan García Elena Bollo de Miguel Alejandro Robles-Pérez Marta Ferrer Galván Cecilia Mouronte Roibas Susana Herrera Lara Guadalupe Bermudo Marta García Moyano Jose Antonio Rodríguez Portal Jacobo Sellarés Torres Javier Narváez María Molina-Molina
author_sort	Esteban Cano-Jiménez
title	Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
title_short	Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
title_full	Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
title_fullStr	Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
title_full_unstemmed	Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
title_sort	diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e334e345eec5491a94d1f3b8b69e06c5
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Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis

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