Sex influence on outcomes of patients with systemic sclerosis–associated interstitial lung disease: a EUSTAR database analysis

Medientyp: E-Artikel
Titel: Sex influence on outcomes of patients with systemic sclerosis–associated interstitial lung disease: a EUSTAR database analysis
Beteiligte: Campochiaro, Corrado; Hoffmann-Vold, Anna-Maria; Avouac, Jerome; Henes, Jörg; de Vries-Bouwstra, Jeska; Smith, Vanessa; Siegert, Elise; Airò, Paolo; Oksel, Fahrettin; Pellerito, Raffaele; Vanthuyne, Marie; Pozzi, Maria Rosa; Inanc, Murat; Sibilia, Jean; Gabrielli, Armando; Distler, Oliver; Allanore, Yannick; Cerinic, Marco Matucci; Walker, Ulrich; Iannone, Florenzo; Becvar, Radim; Cuomo, Giovanna; Montecucco, C; Carreira, Patricia E; [...]
Erschienen: Oxford University Press (OUP), 2023
Erschienen in: Rheumatology
Sprache: Englisch
DOI: 10.1093/rheumatology/keac660
ISSN: 1462-0332; 1462-0324
Schlagwörter: Pharmacology (medical) ; Rheumatology
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Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Objective</jats:title> <jats:p>Interstitial lung disease (ILD) is the leading cause of morbidity and mortality in systemic sclerosis (SSc) patients. We aimed to investigate the impact of sex on SSc-ILD.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>EUSTAR SSc patients with radiologically confirmed ILD and available percentage predicted forced vital capacity (%pFVC) were included. Demographics and disease features were recorded. A change in %pFVC over 12 months (s.d. 6) (cohort 1) was classified into stable (≤4%), mild (5–9%) and large progression (≥10%). In those with 2-year longitudinal %pFVC (cohort 2), the %pFVC change at each 12-month (s.d. 6) interval was calculated. Logistic regression analyses [odds ratio (OR) and 95% CI] and Cox proportional hazards models adjusted for age and %pFVC were applied.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 1136 male and 5253 female SSc-ILD patients were identified. Males were significantly younger, had a shorter disease duration, had a higher prevalence of CRP elevation and frequently had diffuse cutaneous involvement. In cohort 1 (1655 females and 390 males), a higher percentage of males had stable ILD (74.4% vs 69.4%, P = 0.056). In multivariable analysis, disease duration and %pFVC [OR 0.99 (95% CI 0.98, 0.99) and OR 0.97 (95% CI 0.95, 0.99), respectively] in males and age, %pFVC and anti-centromere [OR 1.02 (95% CI 1.00, 1.04), OR 0.97 (95% CI 0.96, 0.98) and OR 0.39 (95% CI 0.245, 0.63), respectively] in females were associated with large progression. The 1-year mortality rate was higher in males (5.1% vs 2.5%, P = 0.013). In cohort 2 (849 females and 209 males), a higher percentage of females showed periods of large progression (11.7% vs 7.7%, P = 0.023), the percentage of patients with none, one or two periods of worsening was not different. The overall death rate was 30.9% for males and 20.4% in females (P &lt; 0.001). In the survival analysis, male sex was a predictor of mortality [OR 1.95 (95% CI 1.66, 2.28)].</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Male SSc-ILD patients have a poorer prognosis and sex-specific predictors exist in SSc-ILD.</jats:p> </jats:sec>

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