Effect of Biological Disease-modifying Anti-rheumatic Drugs on Airway and Interstitial Lung Disease in Patients with Rheumatoid Arthritis

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  • Kurata Izumi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Tsuboi Hiroto
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Terasaki Mayu
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Shimizu Masaru
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Toko Hirofumi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Honda Fumika
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Ohyama Ayako
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Yagishita Mizuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Osada Atsumu
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Ebe Hiroshi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Kawaguchi Hoshimi
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Takahashi Hiroyuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Hagiwara Shinya
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Asashima Hiromitsu
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Kondo Yuya
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Matsumoto Isao
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
  • Sumida Takayuki
    Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan

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<p>Objective Biological disease-modifying anti-rheumatic drugs (bDMARDs) represent an important advance in alleviating rheumatoid arthritis (RA), but their effect on rheumatic airway disease (AD) and interstitial lung disease (ILD) is still unclear. This study was performed to evaluate the association of the use of different bDMARDs with new-onset or worsening of RA-AD/ILD. </p><p>Methods We performed a retrospective cohort study of RA patients who received bDMARDs and assessed their AD/ILD before and after drug initiation in our hospital over the past 10 years. We evaluated the serial changes in computed tomography (CT), classified patients according to AD/ILD progression, and analyzed associations between clinical characteristics and outcomes. </p><p>Results We enrolled 49 patients. Thirty patients received tumor necrosis factor inhibitors (TNFis), 12 received abatacept (ABT), and the remaining 7 received tocilizumab (TCZ). Seventeen patients had ILD, 10 had AD, and 6 had both AD and ILD before the initiation of bDMARDs. New emergence or exacerbation of AD/ILD was observed in 18 patients after drug initiation, while the remaining 31 remained stable or improved. Multiple logistic regression analyses revealed that pre-existing AD was an independent risk factor against the emergence or exacerbation of RA-AD/ILD, and ABT use was a protective factor against it. </p><p>Conclusion Our study showed that pre-existing RA-AD is associated with future worsening of RA-AD/ILD, and ABT over other bDMARDs was associated with a better prognosis. Future studies to confirm our results are needed. </p>

Journal

  • Internal Medicine

    Internal Medicine 58 (12), 1703-1712, 2019-06-15

    The Japanese Society of Internal Medicine

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