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Factors affecting treatment outcome in patients with idiopathic nonspecific interstitial pneumonia: a nationwide cohort study

Authors
Lee, Sang HoonPark, Moo SukKim, Song YeeKim, Dong SoonKim, Young WhanChung, Man PyoUh, Soo TaekPark, Choon SikPark, Sung WooJeong, Sung HwanPark, Yong BumLee, Hong LyeolShin, Jong WookLee, Eun JooLee, Jin HwaJegal, YanginLee, Hyun KyungKim, Yong HyunSong, Jin WooPark, Jong Sun
Issue Date
6-12월-2017
Publisher
BIOMED CENTRAL LTD
Keywords
Non-specific interstitial pneumonia; Treatment; Pulmonary lung function
Citation
RESPIRATORY RESEARCH, v.18
Indexed
SCIE
SCOPUS
Journal Title
RESPIRATORY RESEARCH
Volume
18
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/81207
DOI
10.1186/s12931-017-0686-7
ISSN
1465-9921
Abstract
Background: The effects of corticosteroid-based therapy in patients with idiopathic nonspecific interstitial pneumonia (iNSIP), and factors affecting treatment outcome, are not fully understood. We aimed to investigate the long-term treatment response and factors affecting the treatment outcome in iNSIP patients from a multi-center study in Korea. Methods: The Korean interstitial lung disease (ILD) Study Group surveyed ILD patients from 2003 to 2007. Patients were divided into two groups to compare the treatment response: response group (forced vital capacity (FVC) improves = 10% after 1 year) and non-response group (FVC < 10%). Factors affecting treatment response were evaluated by multivariate logistic regression analysis. Results: A total of 261 patients with iNSIP were enrolled, and 95 patients were followed-up for more than 1 year. Corticosteroid treatment was performed in 86 patients. The treatment group showed a significant improvement in lung function after 1-year: FVC, 10.0%; forced expiratory volume (FEV1), 9.8%; diffusing capacity of the lung for carbon monoxide (DLco), 8.4% (p < 0.001). Sero-negative anti-nuclear antibody (ANA) was significantly related with lung function improvement. Sero-positivity ANA was significantly lower in the response group (p = 0.013), compared to that in the non-response group. A shorter duration of respiratory symptoms at diagnosis was significantly associated with a good response to treatment (p = 0.018). Conclusion: Treatment with corticosteroids and/ or immunosuppressants improved lung function in iNSIP patients, which was more pronounced in sero-negative ANA and shorter symptom duration patients. These findings suggest that early treatment should be considered in iNSIP patients, even in an early disease stage.
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