Pneumologie 2020; 74(S 01): 55
DOI: 10.1055/s-0039-3403181
Posterbegehung (PO10) – Sektion Klinische Pneumologie
Therapiefortschritte bei Kollagenose-assoziierten ILDs & pulmonaler Hypertonie
Georg Thieme Verlag KG Stuttgart · New York

Does anti-acid treatment influence disease progression in SSc-ILD? Data form the German SSc-network

M Kreuter
1   Zentrum für Interstitielle und Seltene Lungenerkrankungen, Pneumologie und Beatmungsmedizin, Thoraxklinik; Universitätsklinikum Heidelberg und Translationales Zentrum für Lungenforschung Heidelberg (Tlrc); Mitglied des Deutschen Zentrums für Lungenforschung (Dzl)
,
F Bonella
2   Unit for Interstitial Lung Diseases, Ruhrlandklinik University Hospital Essen
,
N Blank
3   Rheumatology, University Hospital Heidelberg
,
E Siegert
4   Rheumatology, Charité Universitätsmedizin Berlin
,
J Henes
5   Rheumatology, University Hospital Tuebingen
,
M Worm
6   Dermatology, Charité Universitätsmedizin Berlin
,
C Sunderkoetter
7   Dermatology, University Hospital Muenster
,
M Schmalzing
8   Rheumatology, University Hospital Wuerzburg
,
A Kreuter
9   Dermatology, Helios St. Elisabeth Klinik Oberhausen
,
C Guenther
10   Dermatology, University Hospital Carl Gustav Carus, Dresden
,
L Susok
11   Dermatology, St. Josef Hospital Bochum
,
G Zeidler
12   Rheumatology, Johanniter-Krankenhaus Im Fläming Treuenbrietzen
,
I Koetter
13   Rheumatology, Asklepios Klinik Altona, Hamburg
,
U Mueller-Ladner
14   Rheumatology, Kerckhoff Clinic Bad Nauheim
,
T Krieg
15   Dermatology, University Hospital Cologne
,
A Juche
16   Immanuel Krankenhaus Berlin-Buch
,
T Schmeiser
17   Rheumatology, Krankenhaus St. Josef, Wuppertal
,
G Riemekasten
18   Rheumatology, University Medical Center-UKSH, Luebeck
,
E Aberer
19   Dermatology, University Hospital Graz, Austria
,
N Gaebelein-Wissing
20   Dermatology, Helios University Hospital Wuppertal
,
JHW Distler
21   Rheumatology, University Hospital Erlangen
,
M Sárdy
22   Dermatology, Ludwig Maximilians University Hospital, Munich
,
C Pfeiffer
23   Dermatology, University Medical Center Ulm
,
K Kuhr
24   Imsb, University of Cologne
,
HM Lorenz
3   Rheumatology, University Hospital Heidelberg
,
P Moinzadeh
15   Dermatology, University Hospital Cologne
,
N Hunzelmann
15   Dermatology, University Hospital Cologne
› Author Affiliations
Further Information

Publication History

Publication Date:
28 February 2020 (online)

Also available at
 

Background: Gastroesophageal reflux (GER) is common in SSc and thus treatment with anti-acid therapy (AAT) is frequent. An association between GER and SSc-ILD progression has been hypothesized. However, outcomes of AAT on disease progression in SSc-ILD has only sparsely been studied.

Methods: The German Network for Systemic Scleroderma (DNSS), which includes SSc pts. prospectively, was analyzed for SSc-ILD. Those without SSc progression at ILD 1st diagnosis were categorized in AAT vs. no-AAT users and outcome was assessed.

Results: SSc-ILD was reported in 1886 out of 4306 pts. 929 of SSc-ILD pts had no disease progression at ILD 1st diagnosis. 514 used AAT while 415 did not. Baseline characteristics were similar with regards to age, gender, BMI, time since SSc diagnosis, mRSS, esophageal involvement and steroid use. Significant differences in no-AAT vs. AAT were found for lung function (PFT: DLCO 63% vs. 58%, p < 0.001; FVC85% vs. 78%, p = 0.003) and immunosuppressant use (43% vs. 50%, p = 0.005). Disease progression (defined as either death or decline of FVC ≥ 10% or DLCO ≥ 15%) was significantly higher in AAT vs. no-AAT (31% vs. 25%, p = 0.006). Yet, mortality was lower in AAT (11% vs. no-AAT 18.5%, p < 0.001), while there was a significant higher rate of FVC ≥ 10% decline with 32% in the AAT compared to 18% in no-AAT (p = 0.024) while no difference for a decline in DLCO ≥ 15% was found (p = 0.136).

Conclusions: This current analysis suggests, that AAT use may be correlated with ILD progression in SSc. Yet, results may have been biased by differences in baseline PFT and favorable survival effects have to be respected. Prospective trials are needed to assess the impact of AAT in SSc-ILD.