| Item type |
学術雑誌論文 / Journal Article(1) |
| 公開日 |
2022-07-04 |
| タイトル |
|
|
タイトル |
Clinical significance of interstitial lung disease and its acute exacerbation in microscopic polyangiitis |
|
言語 |
en |
| 言語 |
|
|
言語 |
eng |
| 資源タイプ |
|
|
資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
|
資源タイプ |
journal article |
| その他のタイトル |
|
|
その他のタイトル |
ILD and AE in MPA |
| 著者 |
Hozumi, Hironao
Kono, Masato
Hasegawa, Hirotsugu
Yasui, Hideki
Suzuki, Yuzo
Karayama, Masato
Furuhashi, Kazuki
Enomoto, Noriyuki
Fujisawa, Tomoyuki
Inui, Naoki
Nakamura, Yutaro
Yokomura, Koshi
Nakamura, Hidenori
Suda, Takafumi
|
| 書誌情報 |
Chest
巻 159,
号 6,
p. 2334-2345,
発行日 2021-06
|
| 出版者 |
|
|
出版者 |
Elsevier |
| 権利 |
|
|
権利情報 |
Copyright 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| 権利 |
|
|
権利情報 |
This is the accepted manuscript version. The formal published version is available at https://doi.org/10.1016/j.chest.2021.01.083. |
| 抄録 |
|
|
内容記述タイプ |
Abstract |
|
内容記述 |
BACKGROUND: Presence of interstitial lung disease (ILD) is believed to be associated with mortality in microscopic polyangiitis (MPA); however, evidence on MPA-ILD remains lacking. Acute exacerbation (AE) refers to rapidly progressive, fatal respiratory deterioration that may develop in patients with various ILDs. No study has investigated the clinical significance of AE in MPA-ILD.
QUESTION: We aimed to determine the clinical picture and prognostic factors, the incidence of AE and its risk factors in patients with MPA-ILD.
STUDY DESIGN AND METHODS: Eighty-four consecutive patients with MPA-ILD and 95 patients with MPA-non-ILD were analyzed. We also compared 80 patients with MPA-ILD and 80 patients with idiopathic interstitial pneumonia without myeloperoxidase-anti-neutrophil cytoplasmic antibody-positivity (ILD-alone), who were matched for age, sex, and chest high-resolution computed tomography pattern.
RESULTS: The MPA-ILD group had a higher frequency of men and smokers and was associated with higher mortality than the MPA-non-ILD group. The matched MPA-ILD group had a higher mortality rate than the matched ILD-alone group. There was no significant difference in AE incidence between the matched MPA-ILD and ILD-alone groups (1-year AE cumulative incidence rate: 7.5% and 5.2%, respectively, P=0.75). In the MPA-ILD group, a lower percent-predicted forced vital capacity (%FVC) was independently associated with a higher mortality rate (hazard ratio [HR]: 0.96 per 1% increase, P<0.01) and a higher AE incidence rate (HR: 0.96 per 1% increase, P=0.01). On multivariable Cox regression analysis with time-dependent covariates, developing AE during their clinical course was strongly associated with shorter survival (HR:17.1, P<0.001).
INTERPRETATION: MPA-ILD represented a distinct phenotype with poor prognosis. Lower %FVC was an independent prognostic factor. Patients with lower %FVC had a risk of terminant. The specific management for MPA-ILD and AE should be established. |
| ISSN |
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収録物識別子タイプ |
ISSN |
|
収録物識別子 |
0012-3692 |
| EISSN |
|
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収録物識別子タイプ |
ISSN |
|
収録物識別子 |
1931-3543 |
| PubMed番号 |
|
|
関連タイプ |
isVersionOf |
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|
識別子タイプ |
PMID |
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|
関連識別子 |
33571506 |
| 出版社DOI |
|
|
関連タイプ |
isVersionOf |
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|
識別子タイプ |
DOI |
|
|
関連識別子 |
10.1016/j.chest.2021.01.083 |
| 著者版フラグ |
|
|
出版タイプ |
AM |
|
出版タイプResource |
http://purl.org/coar/version/c_ab4af688f83e57aa |
Chest-159-2334.pdf (1.4 MB)
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