Predicting treatment outcomes and responder subsets in scleroderma-related interstitial lung disease.
Predicting treatment outcomes and responder subsets in scleroderma-related interstitial lung disease.
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DOI：
10.1002/art.30438
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发表时间：
2011-09
影响因子：
--
通讯作者：
Elashoff, Robert M.
中科院分区：
文献类型：
--
作者：
Roth, Michael D.;Tseng, Chi-Hong;Clements, Philip J.;Furst, Daniel E.;Tashkin, Donald P.;Goldin, Jonathan G.;Khanna, Dinesh;Kleerup, Eric C.;Li, Ning;Elashoff, David;Elashoff, Robert M.
确定硬皮病相关间质性肺疾病（SSc-ILD）患者的基线特征，这些特征可预测口服环磷酰胺（CYC）治疗12个月后的最佳缓解。对硬皮病肺研究数据进行了回顾性回归分析，以确定与用力肺活量（FVC）预测值%的绝对变化和FVC预测值%随时间的安慰剂校正变化（CYC治疗效应）相关的基线特征。硬皮病肺研究的CYC组完成与12个月时安慰剂校正的FVC %预测值改善相关，为2.11%，当患者再随访6个月时增加至4.16%（p=0.014）。多变量回归分析将基线高分辨率计算机断层扫描（HRCT）、改良Rodnan皮肤评分（mRSS）和Mahler基线呼吸困难指数（BDI）上的网状浸润的最大严重程度确定为治疗反应的独立相关因素。当根据HRCT上是否有50%或更多的肺区被网状浸润和/或mRSS至少为23来对患者进行分层时，出现了一个亚组，12个月时平均CYC治疗效果为4.73%，18个月时为9.81%（p<0.001）。相反，在HRCT结果不太严重和mRSS较低的患者中没有治疗效果（-0.58%）。硬皮病肺研究的回顾性分析发现，基线HRCT和基线mRSS上网状浸润的严重程度是可能预测对CYC治疗反应性的患者特征。
To identify baseline characteristics of patients with Scleroderma-Related Interstitial Lung Disease (SSc-ILD) which predict the most favorable response to a 12-month treatment with oral cyclophosphamide (CYC). Regression analyses were retrospectively applied to the Scleroderma Lung Study data in order to identify baseline characteristics that correlated with the absolute change in %-predicted Forced Vital Capacity (FVC) and the placebo-adjusted change in %-predicted FVC over time (the CYC treatment effect). Completion of the CYC arm of the Scleroderma Lung Study was associated with a placebo-adjusted improvement in %-predicted FVC of 2.11% at 12 months which increased to 4.16% when patients were followed for another 6 months (p=0.014). Multivariate regression analyses identified the maximal severity of reticular infiltrates on baseline high-resolution computerized tomography (HRCT), the modified Rodnan Skin Score (mRSS), and Mahler's Baseline Dyspnea Index (BDI) as independent correlates of treatment response. When patients were stratified based on whether 50% or more of any lung zone was involved by reticular infiltrates on HRCT and/or the presence of a mRSS of at least 23, a subgroup emerged with an average CYC treatment effect of 4.73% at 12 months and 9.81% at 18 months (p<0.001). Conversely, there was no treatment effect (−0.58%) in patients with less severe HRCT findings and a lower mRSS. A retrospective analysis of the Scleroderma Lung Study identified the severity of reticular infiltrates on baseline HRCT and the baseline mRSS as patient features that might predict responsiveness to CYC therapy.
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影响因子：
--
作者：
STEEN, VD;CONTE, C;MEDSGER, TA
通讯作者：
MEDSGER, TA
影响因子：
39.2
作者：
White, B;Moore, WC;Wise, RA
通讯作者：
Wise, RA
影响因子：
158.5
作者：
Tashkin, Donald P.;Elashoff, Robert;Metersky, Mark
通讯作者：
Metersky, Mark
影响因子：
1.6
作者：
Ferri, C;Valentini, G;Tirri, G
通讯作者：
Tirri, G
影响因子：
5.5
作者：
Hanitsch, L. G.;Burmester, G. -R.;Riemekasten, G.
通讯作者：
Riemekasten, G.