Methotrexate, leflunomide, and tacrolimus use and the progression of rheumatoid arthritis-associated interstitial lung disease
- Abstract
- Objective: To examine the association between MTX, LEF and tacrolimus use and the progression of RA-associated interstitial lung disease (ILD).
Methods: The Korean RA-ILD cohort prospectively enrolled patients with RA-associated ILD at multiple centres from 2015 to 2018 and followed up with them for 3 years. ILD progression was defined by any of the followings: a decrease of ≥10% in forced vital capacity, a decrease of ≥15% in the diffusing capacity of the lung for carbon monoxide, or death from respiratory failure.
Results: Of 143 patients, 64 patients experienced ILD progression during a median follow-up period of 33 months. The use of MTX [adjusted hazard ratio (aHR), 1.06; 95% CI, 0.59, 1.89], LEF (aHR, 1.75; 95% CI, 0.88, 3.46) and tacrolimus (aHR, 0.94; 95% CI, 0.52, 1.72) did not increase the risk of ILD progression. However, the association between LEF use and the risk of ILD progression was significant in subgroups with poor lung function (aHR, 8.42; 95% CI, 2.61, 27.15). Older age, male sex, a shorter RA duration, higher RA disease activity and extensive disease at baseline were independently associated with ILD progression.
Conclusion: None of the three treatments increased the risk of RA-associated ILD progression, except for LEF, which increased the risk of ILD progression in patients with severe ILD. The appropriate use of conventional synthetic disease-modifying antirheumatic drugs considering RA disease activity and ILD severity would be important for the management of RA-associated ILD.
- All Author(s)
- J. W. Kim
; S. W. Chung
; J. Y. Pyo
; S. H. Chang
; M. U. Kim
; C. H. Park
; J. S. Lee
; Y. J. Ha
; E. H. Kang
; Y. A. Lee
; Y. B. Park
; E. Y. Lee
; J. Y. Choe
- Issued Date
- 2022
- Type
- Article
- Keyword
- LEF; MTX; RA; interstitial lung disease; progression-free survival; tacrolimus
- Publisher
- British Society for Rheumatology
- ISSN
- 1462-0324
; 1462-0332
- Citation Title
- Rheumatology
- Citation Volume
- 62
- Citation Number
- 7
- Citation Start Page
- 2377
- Citation End Page
- 2385
- Language(ISO)
- eng
- DOI
- 10.1093/rheumatology/keac651
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2098
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