Risk factors for progression and prognosis of primary Sjögren’s syndrome‐associated interstitial lung disease in a Chinese population

Xu, Yuetong; Zhou, Junfei; Dong, Xianjun; Guo, Xiaojuan; Lu, Yuewu; Zheng, Yi

doi:10.1111/1756-185x.14023

Cited by 13 publications

(9 citation statements)

References 24 publications

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“…Several serum biomarkers such as hypoalbuminemia, NLR and increased levels of AST tended to be associated with poor prognosis in our study, although the relationship was not strong. Our results showed that hypoalbuminemia was independently associated with increased mortality in IIM patients, which was similar to data from other studies 7,37 . As described above, albumin has a number of essential physiological effects for normal health 23 .…”

Section: Discussionsupporting

confidence: 92%

Analysis of risk factors of interstitial lung disease and mortality rates in Chinese patients with idiopathic inflammatory myopathy

2021

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Aim To investigate the risk factors for interstitial lung disease (ILD) and prognosis in patients with idiopathic inflammatory myopathy (IIM). Methods A retrospective longitudinal study was performed in patients diagnosed with IIM between January 2012 and December 2018. Results The study cohort included 91 men and 195 women who were classified as having dermatomyositis (DM, n = 183), polymyositis (PM, n = 77), or clinical amyopathic DM (CADM, n = 26). ILD was identified in 46.5% (n = 133) of patients with IIM. The independent risk factors for ILD were age at disease onset, presence of anti‐Ro‐52 antibody, Gottron's papules, elevated serum immunoglobulin M levels and hypoalbuminemia. Older age at disease onset, ILD, malignancy, and increased serum aspartate aminotransferase and neutrophil‐to‐lymphocyte ratio (NLR) were identified as the independent predictors for mortality, whereas elevated serum albumin level was associated with a better prognosis. A total of 73 deaths (25.5%) occurred after a median follow‐up time of 33 months. Infection (49.3%) was the leading cause of death. In the overall cohort, the 1‐year, 5‐year and cumulative survival rates were 83.2%, 74.2% and 69.4%, respectively. The receiver operating characteristic curve indicated that the optimal cut‐off value of NLR for predicting death in IIM was 6.11. Conclusion IIM patients have a poor prognosis with substantial mortality, especially in patients who have older age at onset, ILD, malignancy and higher NLR. Close monitoring and aggressive therapies are required in patients having poor predictive factors.

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Section: Discussionsupporting

confidence: 92%

Analysis of risk factors of interstitial lung disease and mortality rates in Chinese patients with idiopathic inflammatory myopathy

2021

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“…In our study, serum LDH level was higher in the lung‐onset group ( p = .018), and was negatively correlated with TCL (%pred). In addition, hypoproteinemia was a risk factor for the progression of ILD and an independent risk factor for mortality in pSS‐ILD patients 8,41 . In our cohort, the serum level of ALB significantly decreased in both groups.…”

Section: Discussionmentioning

confidence: 53%

“…In addition, hypoproteinemia was a risk factor for the progression of ILD and an independent risk factor for mortality in pSS-ILD patients. 8,41 In our cohort, the serum level of ALB significantly decreased in both groups. HRCT score was negatively correlated with serum ALB.…”

Section: Discussionmentioning

confidence: 54%

The characteristics of chest HRCT and pulmonary function tests in lung‐onset primary sjogren's syndrome

Dong

Gao

et al. 2023

Immunity Inflam & Disease

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IntroductionInterstitial lung disease (ILD) can manifest before the diagnosis of primary Sjögren's syndrome (pSS), however, the underlying mechanisms remain unclear. The aim of this study is to investigate the characteristics of lung‐onset pSS using chest high‐resolution computerized tomography (HRCT) and pulmonary function tests (PFTs).MethodsThe data of 102 patients with pSS‐ILD were retrospectively analyzed. The patients were divided into two groups: lung‐onset group and the nonlung‐onset group. The chest HRCT, PFTs, and clinical and laboratory data were evaluated and compared.ResultsAmong the 102 patients with pSS‐ILD, 59 (57.8%) were lung‐onset and 43 (42.2%) were nonlung‐onset. Chest HRCT in the lung‐onset group showed higher percentage of usual interstitial pneumonia and nonspecific interstitial pneumonia, the difference did not reach statistical significance. The total HRCT score was higher in the lung‐onset group, compared with the nonlung‐onset group (2 [2, 3], vs. 2 [1, 2], p = .014). Total lung capacity (TLC) (%pred) [(75.4 ± 16.2) versus (82.8 ± 19.4), p = .049] and forced vital capacity (FVC) (%pred) [(82.2 ± 19.9) versus (91.6 ± 28.3), p = .050] were significantly lower in the lung‐onset group, compared with the nonlung‐onset group. Residual volume (RV)/TLC (%) significantly increased more than 40% in the lung‐onset group (p = .015). Restricted ventilation disorder, small airway obstruction and reduced diffusing capacity of the lung for carbon monoxide/alveolar volume (%Pred) were more common in the lung‐onset group (p = .038, p = .050, and p = .050, respectively). Correlation analysis showed that HRCT score was positively correlated with the interval between the onset of pulmonary symptoms and the diagnosis of ILD, serum CA125, and serum CEA. TCL (%pred), VC (%pred), FVC (%pred) were negatively correlated with serum CA125.ConclusionLung‐onset is common in pSS patients with more severe lung function impairments. Serum biomarkers, such CA125, CEA, and ALB, were associated with the severity of lung damage.

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“…Therefore, it is necessary to further identify those patients who have both imaging pulmonary interstitial changes and high clinical risk. In a study, Xu et al found that extensive lung involvement is an independent risk factor for the progression of ILD in patients with pSS, and hypoproteinemia is an independent risk factor for death in such patients (34). In another study conducted by Kamiya et al, the authors found that lower percentage of forced vital capacity and higher serum Krebs von den Lungen-6 (KL-6) levels are predictors of poor prognosis in patients with pSS-ILD (35).…”

Section: Discussionmentioning

confidence: 99%

The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

Zhang¹,

Li²,

Cai³

et al. 2021

Ann Palliat Med

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Background: During the course of disease, some patients with primary Sjögren's syndrome (pSS) develop interstitial lung disease (ILD), which leads to a poor prognosis. There is currently a lack of methods to identify high-risk patients with ILD and predict the prognosis. The purpose of this study was to analyze the predictive value of the neutrophil to lymphocyte ratio (NLR) for the occurrence of ILD and its prognosis in patients with pSS.Methods: According to the inclusion and exclusion criteria, patients with pSS admitted to our hospital from May 2009 to November 2020 were included. The patients were divided into either an ILD group or a non-interstitial pneumonia [non-ILD (NILD)] group. We compared the baseline data of the two groups of participants, and the participants were followed up (≥1 year) at clinic visits. Logistic multivariate regression analysis was used to analyze the risk factors related to ILD and prognosis in patients with pSS.Results: A total of 217 patients with pSS were included, of which 71 (32.7%) participants were diagnosed with ILD (ILD group) at the time of pSS diagnosis, and 146 (67.3%) participants had no obvious ILD (NILD group). Based on follow-up results, logistic multivariate analysis revealed that NLR [relative risk (RR) =1.81,

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Risk factors for progression and prognosis of primary Sjögren’s syndrome‐associated interstitial lung disease in a Chinese population

Cited by 13 publications

References 24 publications

Analysis of risk factors of interstitial lung disease and mortality rates in Chinese patients with idiopathic inflammatory myopathy

Analysis of risk factors of interstitial lung disease and mortality rates in Chinese patients with idiopathic inflammatory myopathy

The characteristics of chest HRCT and pulmonary function tests in lung‐onset primary sjogren's syndrome

The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

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