Treatment and Systemic Sclerosis Interstitial Lung Disease Outcome: The Overweight Paradox
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
6MWT | 6 min walk |
ABGs | arterialized capillary blood gases |
ACAs | anticentromere antibodies |
ANAs | anti-nuclear antibodies |
Anti-dsDNA | antibodies to double-stranded deoxyribonucleic acid |
Anti-RNP | antibodies to ribonucleoprotein |
Anti-SCL-70 | anti-topoisomerase I antibodies |
Anti-SSA | Ro autoantibodies |
Anti-SSB | anti-La antibodies |
ATS | American Thoracic Society |
BMI | body mass index |
COPD | chronic obstructive pulmonary disease |
CYC | cyclophosphamide |
dcSSc | diffuse cutaneous SSc |
DLCO | diffusing capacity for carbon monoxide |
ERS | European Respiratory Society |
EULAR-ACR | American College of Rheumatology/European League Against Rheumatism Collaborative Initiative |
FEV1 | forced expiratory volume in 1 s |
FVC | forced vital capacity |
GGOs | ground glass opacities |
GIT | gastrointestinal tract |
HRCT | high-resolution computed tomography |
ILD | interstitial lung disease |
IPF | idiopathic pulmonary fibrosis |
ISU | immunosuppressive |
KLCO | transfer coefficient of the lung for carbon monoxide |
lcSSc | limited cutaneous SSc |
LF | lung function |
MDT | multidisciplinary ILD-team |
MMF | mycophenolate mofetil |
NSIP | non-specific interstitial pneumonia |
pCO2 | partial pressure of carbon dioxide |
PF-ILD | progressive fibrosing interstitial lung disease |
pO2 | partial pressure of oxygen |
pUIP | probable usual interstitial pneumonia |
RF | rheumatoid factor |
SENSCIS | A Trial to Compare Nintedanib with Placebo for Patients With Scleroderma-Related Lung Fibrosis |
SLS | Scleroderma Lung Study |
SpO2 | oxygen saturation |
SSc | systemic sclerosis |
ssSSc | sine scleroderma SSc |
TLC | total lung capacity |
UIP | usual interstitial pneumonia |
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Parameters | All Patients (n = 54) # | No Treatment (n = 12) | ISU Therapy (n = 21) | Biological Therapy (n = 9) |
---|---|---|---|---|
Age (year) | 58.7 ± 13.3 | 66.1 ± 13.7 | 59.12 ± 12.4 | 62.7 ± 10.0 |
Sex (male: female) n (%) | 7:47 (13.0:87.0) | 1:11 (8.3:91.7) | 3:18 (14.3:85.7) | 1:8 (11.1:88.9) |
GAP score n (%) | ||||
Stage I (0–3 points) | 48 (88.9) | 12 (100) | 20 (95.2) | 8 (88.9) |
Stage II (4–5 points) | 6 (11.1) | 0 | 1 (5) | 1 (1.1) |
Stage III (6–8 points) | 0 | 0 | 0 | 0 |
Ever smoker n (%) Non-smoker n (%) | 14 (25.9) 40 (74.1) | 4 (33.3) 8 (66.7) | 5 (23.8) 16 (76.2) | 2 (22.2) 7 (77.8) |
BMI (kg/m2) | 24.8 ± 4.3 | 23.6 ± 3.1 | 25.0 ± 4.4 | 26.4 ± 4.5 |
Overweight n (%) | 21 (38.9) | 3 (25.0) | 8 (38.1) | 5 (55.6) |
PF-ILD n (%) | 15 (27.8) | 5 (41.7) | 7 (33.3) | 3 (33.3) |
Symptoms n (%) | ||||
Dyspnea | 26 (48.2) | 6 (50.0) | 8 (38.1) | 5 (55.6) |
Cough | 15 (27.8) | 4 (33.3) | 1 (4.8) * | 4 (44.4) |
Chest pain | 5 (9.3) | 0 | 0 | 0 |
Joint pain | 8 (14.8.) | 1 (8.3) | 5 (23.8) | 1 (11.1) |
Clubbing | 1 (1.91) | 0 | 0 | 1 (11.1) |
Weight loss | 3 (5.6%) | 1 (8.3) | 1 (4.9) | 1 (11.1) |
Crackles | 15 (27.8) | 5 (41.7) | 6 (28.6) | 2 (22.2) |
Raynaud’s phenomenon | 38 (70.5) | 8 (66.7) | 13 (61.9) | 5 (55.6) |
GIT involvement | 10 (18.5) | 5 (41.7) *** | 2 (9.5) | 3 (33.3) |
HRCT pattern n (%) | ||||
NSIP n | 34 (63.0) | 11 (91.7) | 15 (71.4) | 3 (33.3) ** |
UIP/pUIP n | 8 (14.8) | 1 (8.3) | 2 (9.5) | 4 (44.4) *** |
Other or no data n | 10 (18.5) | 0 | 4 (19.0) | 2 (22.2) |
Serological pattern n (%) | ||||
ANA | 23 (42.6) | 8 (66.7) | 12 (57.1) | 3 (33.3) |
ACA | 1 (1.9) | 1 (8.3) | 0 | 0 |
RF | 3 (5.6) | 2 (1.7) | 1 (4.8) | 0 |
ACCP | 1 (1.9) | 0 | 1 (4.8) | 0 |
Anti-RNA-polymerase | 2 (3.7) | 1 (8.3) | 1 (4.8) | 0 |
Anti-cytoplasmatic | 5 (9.3) | 1 (8.3) | 2 (9.5) | 2 (22.2) |
Anti-chromatin | 12 (22.2) | 5 (41.7) | 6 (28.6) | 1 (11.1) |
Anti-Smith | 1 (1.9) | 1 (8.3) | 0 | 0 |
Anti-Jo-1 | 1 (1.9) | 0 | 1 (4.8) | 0 |
Anti-SSA | 2 (3.7) | 0 | 2 (9.5) | 0 |
Anti-SSB | 1 (1.9) | 1 (8.3) | 0 | 0 |
Anti-SCL-70 | 18 (33.3) | 8 (66.7) | 9 (42.9) ** | 1 (11.1) |
Anti-RNP | 4 (7.4) | 3 (25) | 1 (4.8) | 0 |
Anti-dsDNA | 3 (5.6) | 1 (8.3) | 1 (4.8) | 1 (11.1) |
Parameters | All Patients (n = 54) | No Treatment (n = 12) | ISU Therapy (n = 21) | Biological Therapy (n = 9) |
---|---|---|---|---|
Lung function | ||||
FVC (L) | 2.5 ± 0.8 | 2.5 ± 0.8 | 2.8 ± 0.8 | 2.2 ± 0.6 |
FVC (%predicted) | 89.8 ± 23.2 | 97.6 ± 21.7 | 92.4 ± 26.6 | 82.2 ± 17.2 |
FEV1(L) | 2.2 ± 0.6 | 2.1 ± 0.6 | 2.3 ± 0.7 | 2.0 ± 0.6 |
FEV1(%predicted) | 90.2 ± 21.8 | 97.9 ± 21.6 | 92.2 ± 23.1 | 85.3 ± 21.5 |
FEV1/FVC (%) | 84.7 ± 6.3 | 83.4 ± 6.3 | 84.9 ± 4.9 | 86.9 ± 12.4 |
TLC (L) | 3.9 ± 1.1 | 4.0 ± 1.0 | 4.1 ± 1.4 | 3.8 ± 1.0 |
TLC (%predicted) | 78.4 ± 21.0 | 81.4 ± 16.2 | 81.1 ± 23.0 | 79.2 ± 23.4 |
Diffusion parameters | ||||
DLCO (mmol/min/kPa) | 5.9 ± 2.0 | 6.2 ± 1.8 | 6.2 ± 2.1 | 5.1 ± 1.3 |
DLCO (%predicted) | 75.2 ± 22.0 | 86.9 ± 24.5 | 77.4 ± 20.7 | 66.7 ± 14.7 |
KLCO (mmol/min/kPa/L) | 1.4 ± 0.4 | 1.3 ± 0.3 | 1.4 ± 0.4 | 1.3 ± 0.3 |
KLCO (%predicted) | 70.0 ± 18.1 | 66.0 ± 15.6 | 70.5 ± 18.9 | 67.0 ± 16.7 |
ABG | ||||
pH | 7.4 ± 0.0 | 7.4 ± 0.0 | 7.4 ± 0.0 | 7.4 ± 0.1 |
pCO2 (mmHg) | 38.0 ± 4.7 | 34.4 ± 3.1 | 43.4 ± 11.1 | 36.7 ± 3.6 |
pO2 (mmHg) | 74.2 ± 10.5 | 84.2 ± 13.1 | 71.2 ± 12.1 | 72.2 ± 14.6 |
6MWT | ||||
Distance (m) | 444.2 ± 119.8 | 365.3 ± 233.9 | 468.8 ± 108.0 | 342.0 ± 106.6 |
SpO2 baseline (%) | 94.9 ± 2.8 | 96.7 ± 3.2 | 97.3 ± 2.1 | 93.9 ± 4.4 |
SpO2 post-exercise (%) | 89.9 ± 10.0 | 82.7 ± 19.9 | 95.3 ± 2.4 | 87.6 ± 8.1 |
Desaturation (%) | 4.9 ± 9.3 | 14.0 ± 16.6 | 2.5 ± 2.4 | 8.0 ± 6.3 |
Pulse baseline (1/min) | 84.8 ± 14.6 | 78.7 ± 11.9 | 82.9 ± 9.6 | 86.4 ± 11.6 |
Pulse post-exercise (1/min) | 108.5 ± 23.1 | 100.3 ± 29.5 | 108.4 ± 17.6 | 106.7 ± 26.4 |
Borg scale baseline (0–10) | 0.2 ± 0.5 | 1.7 ± 2.9 | 0.1 ± 0.3 | 1.0 ± 1.4 |
Borg scale post-exercise (0–10) | 1.8 ± 2.5 | 2.7 ± 3.8 | 1.6 ± 1.2 | 3.1 ± 2.5 |
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Nagy, A.; Palmer, E.; Polivka, L.; Eszes, N.; Vincze, K.; Barczi, E.; Bohacs, A.; Tarnoki, A.D.; Tarnoki, D.L.; Nagy, G.; et al. Treatment and Systemic Sclerosis Interstitial Lung Disease Outcome: The Overweight Paradox. Biomedicines 2022, 10, 434. https://doi.org/10.3390/biomedicines10020434
Nagy A, Palmer E, Polivka L, Eszes N, Vincze K, Barczi E, Bohacs A, Tarnoki AD, Tarnoki DL, Nagy G, et al. Treatment and Systemic Sclerosis Interstitial Lung Disease Outcome: The Overweight Paradox. Biomedicines. 2022; 10(2):434. https://doi.org/10.3390/biomedicines10020434
Chicago/Turabian StyleNagy, Alexandra, Erik Palmer, Lorinc Polivka, Noemi Eszes, Krisztina Vincze, Eniko Barczi, Aniko Bohacs, Adam Domonkos Tarnoki, David Laszlo Tarnoki, György Nagy, and et al. 2022. "Treatment and Systemic Sclerosis Interstitial Lung Disease Outcome: The Overweight Paradox" Biomedicines 10, no. 2: 434. https://doi.org/10.3390/biomedicines10020434
APA StyleNagy, A., Palmer, E., Polivka, L., Eszes, N., Vincze, K., Barczi, E., Bohacs, A., Tarnoki, A. D., Tarnoki, D. L., Nagy, G., Kiss, E., Maurovich-Horvat, P., & Müller, V. (2022). Treatment and Systemic Sclerosis Interstitial Lung Disease Outcome: The Overweight Paradox. Biomedicines, 10(2), 434. https://doi.org/10.3390/biomedicines10020434