Male sex, a usual interstitial pneumonia pattern on high-resolution computed tomography, and extensive lung involvement are significant risk factors for the progression of systemic autoimmune rheumatic disease-associated interstitial lung disease, according to a recent review.
The systematic review and meta-analysis evaluated determinants of progression, acute exacerbation (AE), and rapidly progressive interstitial lung disease (RP-ILD) in patients with systemic autoimmune rheumatic disease–associated interstitial lung disease (SARD-ILD). This analysis incorporated 50 cohort studies, including 7,948 patients, and identified key risk factors for each condition.
Progression of SARD-ILD was significantly associated with male sex (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.26-3.08), usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT; OR, 1.94; 95% CI, 1.48-2.54), extensive lung involvement (OR, 2.15; 95% CI, 1.66-2.80), and advanced age (OR per year, 1.07; 95% CI, 1.05-1.10). In the AE group, significant risk factors included decreased forced vital capacity (FVC), smoking history, and UIP patterns.
For RP-ILD, commonly linked to idiopathic inflammatory myopathies, high C-reactive protein (CRP) levels (OR, 2.45; 95% CI, 1.87-3.21), Ro-52 positivity (OR, 5.35; 95% CI, 3.46-8.29), and MDA5 antibodies (OR, 2.09; 95% CI, 1.47-2.95) were identified as significant risk factors. The variability in definitions and thresholds for parameters such as age, FVC, and CRP across studies highlighted the need for standardized criteria.
Published in Frontiers in Medicine, the findings highlight the importance of early identification and intervention for high-risk SARD-ILD patients. The authors called for more studies to validate these associations and improve the stratification of patients for targeted management strategies.
This analysis provides clinicians with evidence-based insights to guide risk assessment and optimize care for patients with SARD-ILD.
Full disclosures can be found in the published review.
