Frontiers in Medicine (Nov 2024)

Determinants for worsening in systemic autoimmune rheumatic disease-associated interstitial lung disease: a systematic review and meta-analysis of cohort studies

  • Jiaheng Yao,
  • Jiaheng Yao,
  • Jiaheng Yao,
  • Jun Wang,
  • Luhan Guo,
  • Luhan Guo,
  • Luhan Guo,
  • Peipei Su,
  • Jiansheng Li,
  • Jiansheng Li,
  • Jiansheng Li,
  • Bin Li,
  • Bin Li,
  • Bin Li

DOI
https://doi.org/10.3389/fmed.2024.1465753
Journal volume & issue
Vol. 11

Abstract

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BackgroundTo identify risk factors for progression, acute exacerbation (AE), and the development of rapidly progressive interstitial lung disease (RP-ILD) in Systemic autoimmune rheumatic disease-associated interstitial lung disease (SARD-ILD).MethodsWe systematically searched PubMed, EMBASE, Scopus, the Cochrane Library, and Web of Science databases to identify eligible cohort studies up until January 01, 2024. Two reviewers independently screened the literature and extracted data. We employed the Newcastle-Ottawa Scale (NOS) to assess study quality and performed meta-analyses using STATA software.ResultsThis review included 50 studies. For progression, 28 studies were included, four significant risk factors were identified: male (OR = 1.97, 95% CI 1.26–3.08, p < 0.001), UIP patterns on HRCT (OR = 1.94, 95% CI 1.48–2.54, p < 0.001), extensive lung involvement (OR = 2.15, 95% CI 1.66–2.80, p < 0.001), and age (OR = 1.07, 95% CI 1.05–1.10, p < 0.001); and 11 potential risk factors. Seven studies were included in AE, and three potential risk factors were highlighted: FVC, UIP patterns on HRCT, and smoking history. In RP-ILD, 15 studies were included. Three risk factors were determined: High CRP (OR = 2.45, 95% CI 1.87–3.21, p < 0.001), Ro-52 positivity (OR = 5.35, 95% CI 3.46–8.29, p < 0.001), and MDA5 antibodies (OR = 2.09, 95% CI 1.47–2.95, p < 0.001); along with 10 potential risk factors.ConclusionOur meta-analysis identified male sex, UIP pattern on HRCT, extensive lung involvement, and advanced age as significant risk factors for the progression of SARD-ILD. High CRP, Ro-52 positivity, and MDA5 antibodies were significant risk factors for developing of RP-ILD in patients with IIM. We also discovered several potential risk factors that may be associated with the progression of SARD-ILD and acute exacerbation, as well as the occurrence of RP-ILD in IIM patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/.

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