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DOI: 10.1055/s-0039-3403181
Does anti-acid treatment influence disease progression in SSc-ILD? Data form the German SSc-network
Publikationsverlauf
Publikationsdatum:
28. Februar 2020 (online)
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.