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SYSTEMATIC REVIEW article

Front. Med.
Sec. Rheumatology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1465753
This article is part of the Research Topic Pulmonary Involvement in Systemic Autoimmune Rheumatic Diseases (SARDs): from Diagnostic Tools to Therapeutic Strategies View all 5 articles

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

Provisionally accepted
Jiaheng Yao Jiaheng Yao 1,2,3Jun Wang Jun Wang 1,2Luhan Guo Luhan Guo 1,2,3Peipei Su Peipei Su 4Jiansheng Li Jiansheng Li 1,2,3Bin Li Bin Li 1,2,3*
  • 1 Department of Respiratory Diseases, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan Province, China
  • 2 Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou, Henan Province, China
  • 3 The First Clinical Medical College, Henan University of Chinese Medicine, Zhengzhou, Henan Province, China
  • 4 Department of Rheumatology, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan Province, China

The final, formatted version of the article will be published soon.

    Background: To 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). Methods: We systematically searched PubMed, EMBASE, Scopus, the Cochrane Library, and Web of Science databases to identify eligible cohort studies up until Jan. 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. Results: This review included 50 studies. For progression, 28 studies were included, 4 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. 7 studies were included in AE, and 3 potential risk factors were highlighted: FVC, UIP patterns on HRCT, and smoking history. In RP-ILD, 15 studies were included. 3 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. Conclusion: Our 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.

    Keywords: systemic autoimmune rheumatic disease, Interstitial Lung Disease, progression, Risk factors, Systematic review, Meta-analysis

    Received: 16 Jul 2024; Accepted: 13 Nov 2024.

    Copyright: © 2024 Yao, Wang, Guo, Su, Li and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Bin Li, Department of Respiratory Diseases, First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.