Rheumatoid arthritis-related interstitial lung disease: associations, prognostic factors and physiological and radiological characteristics--a large multicentre UK study

Kelly, Clive; Saravanan, Vadivelu; Nisar, Mohamed; Arthanari, Subha; Woodhead, Felix; Price-Forbes, Alec; Dawson, Julie; Sathi, Navtej; Ahmad, Yasmeen; Koduri, Gouri; Young, Adam

doi:10.1093/rheumatology/keu165

Cited by 441 publications

(384 citation statements)

References 38 publications

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“…However, it may also suggest some degree of heterogeneity in risk based on the underlying disease diagnosis. Even though we included other ILD diagnoses with IPF in this study, outcomes in end-stage fibrotic lung disease that is not IPF has been demonstrated to be comparable [3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the GAP Model and the Lung Allocation Score in Patients with Idiopathic Pulmonary Fibrosis/Interstitial Lung Disease Undergoing Lung Transplantation

Silhan¹

2016

PMRR

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IntroductionIdiopathic Pulmonary Fibrosis (IPF) is a uniformly fatal progressive fibrotic lung disease with a mean survival of 3-5 years; currently lung transplant is the only therapy that prolongs survival [1,2]. Other Interstitial Lung Diseases (ILDs) have a better prognosis in general, but some progress to advanced fibrotic lung disease that is fatal without Lung Transplantation (LT) [3][4][5][6]. In contrast to other solid organ transplant, lung transplantation volumes continue to grow. Over 3,600 adult lung transplant procedures were reported in 2013 according to the International Society of Heart and Lung Transplantation registry, the highest in a single year to date. ILD/IPF is a leading indication for LT, accounting for 29% of all lung transplants worldwide [7,8], and is the most common diagnosis for LT (37%) in the United States [9]. In general, short-and long-term survival post-LT have continued to improve, but the median survival remains quite low at 5.6 years for all diseases, and lower, 4.5 years, for IPF/ILD [7,8]. The one-year survival of all adults who underwent primary lung transplant between January 1990 and June 2013 was 80%, and improved overtime to 84% in the 2009 to 2013 era. However, the one-year survival for IPF remains significantly lower at 73-76% [7][8][9].Individual ILD/IPF patients demonstrate widely variable clinical courses and survival, with some progressing rapidly to death, and others enjoying years of little or no progression [10,11]. Hence, predicting prognosis and timing of referral for LT is imperative for best patient outcome.Historically, individual variables have been associated with mortality in IPF, but none have predicted prognosis in isolation [12][13][14][15], and other clinical prognostic models combining variables have had little impact [16][17][18] due to difficulty in clinical use and lack of validation. The GAP model was designed to develop a multidimensional prognostic staging system initially for IPF, then for other ILDs, by using commonly measured variables, specifically gender (G), age (A), and pulmonary physiology (P) including Forced Vital Capacity (FVC) and Diffusion Limitation of Carbon monoxide (DLCO) ( Table 1). These models performed well in two separate derivation and validation cohorts with c-index of approximately 70 in the GAP-IPF study and c-index of 74 in the modified GAP-ILD study in predicting mortality at 1, 2, and 3 years [6,19].In response to a flawed time-based waiting list, the Lung Allocation Subcommittee was formed by the Organ Procurement and . Several models for predicting mortality risk have been developed including the GAP (gender, age, physiology) model. Similarly, the Lung Allocation Score (LAS) has been shown to predict the risk of mortality within the first year posttransplant. We hypothesized that a disease specific mortality model (GAP) might be superior compared to the predictive power of the LAS model for overall mortality within the first year posttransplant in patients with IPF and ILD. MethodsA retrospective analysis of 7...

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Section: Discussionmentioning

confidence: 99%

Comparison of the GAP Model and the Lung Allocation Score in Patients with Idiopathic Pulmonary Fibrosis/Interstitial Lung Disease Undergoing Lung Transplantation

Silhan¹

2016

PMRR

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“…Некоторые авторы указывают на мужской пол в чис-ле факторов риска развития интерстициального ПЛ [7,8,16,19], в то время как другие исследователи это не под-тверждают. Среди наших пациентов преобладали женщи-ны (90%), при этом все мужчины (10%) имели ПЛ.…”

Section: Discussionunclassified

“…Стоит отметить, что аналогичные результаты получили и другие исследователи [1,19]. Так, в работе Y. Yin и соавт.…”

Section: Discussionunclassified

Complex Clinical and Instrumental Evaluation of Lung Injury in Patients With Rheumatoid Arthritis

Неcтерович¹,

Ночевная²,

Рабик³

et al. 2016

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“…Interstitial Lung Disease (ILD) is the only complication of RA reported to be increasing in prevalence (Bongartz et al 2010). In a study by Kelly et al, 47% of deaths in patients with RA associated ILD (RA-ILD) were directly due to ILD (Kelly et al 2014).…”

Section: Dpld In Ramentioning

confidence: 99%

A case of pulmonary fibrosis associated with rheumatoid arthritis, scleroderma sine scleroderma and ANCA associated vasculitis.

Anand

Joseph

Vera-Vazquez

2014

Indian Journal of Rheumatology

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Rheumatoid arthritis-related interstitial lung disease: associations, prognostic factors and physiological and radiological characteristics--a large multicentre UK study

Cited by 441 publications

References 38 publications

Comparison of the GAP Model and the Lung Allocation Score in Patients with Idiopathic Pulmonary Fibrosis/Interstitial Lung Disease Undergoing Lung Transplantation

Comparison of the GAP Model and the Lung Allocation Score in Patients with Idiopathic Pulmonary Fibrosis/Interstitial Lung Disease Undergoing Lung Transplantation

Complex Clinical and Instrumental Evaluation of Lung Injury in Patients With Rheumatoid Arthritis

A case of pulmonary fibrosis associated with rheumatoid arthritis, scleroderma sine scleroderma and ANCA associated vasculitis.

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