| アブストラクト | OBJECTIVES: We aimed to investigate the effect of intravenous cyclophosphamide (CYC) as the initial therapy in patients with acute exacerbation of rheumatoid arthritis-related interstitial lung disease. METHODS: This was a retrospective observational study. Using the Japanese Diagnosis Procedure Combination inpatient database from July 2010 to March 2018, we identified patients with acute exacerbation of rheumatoid arthritis-related interstitial lung disease (RA-ILD) who received high-dose methylprednisolone within 3 days after admission. RA-ILD was defined as having either the diagnosis of RA-ILD or the diagnoses of both RA and ILD, based on the ICD-10 codes recorded by attending physicians. Patients were divided into two groups: those receiving intravenous CYC within 3 days after admission (CYC group) and those who did not (control group). One-to-four propensity-score matching analyses were performed. RESULTS: A total of 6130 eligible patients were included. After propensity score matching, 129 patients in the CYC group and 516 patients in the control group were further analyzed. 90-day in-hospital mortality, defined as all-cause mortality during hospitalization within 90 days after admission, was not significantly different between the CYC and control groups (50.4% versus 42.2%, hazard ratio 1.20, 95% confidence interval 0.91-1.58). A larger proportion of patients in the CYC group received platelet transfusion than that in the control group (7.0% versus 2.3%, odds ratio 3.05, 95% confidence interval 1.20-7.73). CONCLUSION: In this retrospective database study, the initial therapy with CYC did not show a survival benefit in patients with acute exacerbation of RA-ILD. CYC was associated with a larger proportion of platelet transfusion. |
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| 投稿日 | 2021/8/18 |
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| 投稿者 | Nakamura, Kaito; Ohbe, Hiroyuki; Ikeda, Kei; Uda, Kazuaki; Furuya, Hiroki; Furuta, Shunsuke; Nakajima, Mikio; Sasabuchi, Yusuke; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Nakajima, Hiroshi |
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| ジャーナル名 | Seminars in arthritis and rheumatism |
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| 組織名 | Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba,;Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Japan. Electronic address: K.Ikeda@faculty.chiba-u.jp.;Health, The University of Tokyo, Tokyo, Japan; Emergency and Critical Care;Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan.;Data Science Center, Jichi Medical University, Tochigi, Japan.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medical and Dental Sciences, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/34403813/ |
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