Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Michael Kreuter - , Pädagogische Hochschule Heidelberg (Autor:in)
  • Francesco Bonella - , Universität Duisburg-Essen (Autor:in)
  • Norbert Blank - , Universitätsklinikum Heidelberg (Autor:in)
  • Gabriela Riemekasten - , Universität zu Lübeck (Autor:in)
  • Ulf Müller-Ladner - , Kerckhoff Klinik (Autor:in)
  • Jörg Henes - , Universitätsklinikum Tübingen (Autor:in)
  • Elise Siegert - , Charité – Universitätsmedizin Berlin (Autor:in)
  • Claudia Günther - , Klinik und Poliklinik für Dermatologie, Universitätsklinikum Carl Gustav Carus Dresden (Autor:in)
  • Ina Kötter - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Christiane Pfeiffer - , Klinikum der Ludwig-Maximilians-Universität (LMU) München (Autor:in)
  • Marc Schmalzing - , Universitätsklinikum Würzburg (Autor:in)
  • Gabriele Zeidler - , Center for Rheumatology Brandenburg (Autor:in)
  • Peter Korsten - , Universitätsmedizin Göttingen (Autor:in)
  • Laura Susok - , Katholisches Klinikum Bochum gGmbH (Autor:in)
  • Aaron Juche - , Immanuel Krankenhaus Berlin (Autor:in)
  • Margitta Worm - , Klinik und Poliklinik für Dermatologie (Autor:in)
  • Ilona Jandova - , Universitätsklinikum Freiburg (Autor:in)
  • Jan Ehrchen - , Universitätsklinikum Münster (Autor:in)
  • Cord Sunderkötter - , Universitätsklinikum Halle (Autor:in)
  • Gernot Keyßer - , Universitätsklinikum Halle (Autor:in)
  • Andreas Ramming - , Friedrich-Alexander-Universität Erlangen-Nürnberg (Autor:in)
  • Tim Schmeiser - , Cellitinnen-Krankenhaus St. Josef Wuppertal-Elberfeld (Autor:in)
  • Alexander Kreuter - , Universität Witten/Herdecke (Autor:in)
  • Kathrin Kuhr - , Universitätsklinikum Köln (Autor:in)
  • Hanns-Martin Lorenz - , Universität Duisburg-Essen (Autor:in)
  • Pia Moinzadeh - , Universitätsklinikum Köln (Autor:in)
  • Nicolas Hunzelmann - , Universitätsklinikum Köln (Autor:in)

Abstract

OBJECTIVES: Gastroesophageal reflux disease (GERD) occurs frequently in patients with SSc. We investigated whether the presence of GERD and/or the use of anti-acid therapy, specifically proton-pump inhibitors (PPIs), are associated with long-term outcomes, especially in SSc-associated interstitial lung disease (SSc-ILD).

METHODS: We retrospectively analysed patients with SSc and SSc-ILD from the German Network for Systemic Sclerosis (DNSS) database (2003 onwards). Kaplan-Meier analysis compared overall survival (OS) and progression-free survival (PFS) in patients with GERD vs without GERD (SSc and SSc-ILD), and PPI vs no PPI use (SSc-ILD only). Progression was defined as a decrease in either percentage predicted forced vital capacity of ≥10% or single-breath diffusing capacity for carbon monoxide of ≥15%, or death.

RESULTS: It was found that 2693/4306 (63%) registered patients with SSc and 1204/1931 (62%) with SSc-ILD had GERD. GERD was not associated with decreased OS or decreased PFS in patients in either cohort. In SSc-ILD, PPI use was associated with improved OS vs no PPI use after 1 year [98.4% (95% CI: 97.6, 99.3); n = 760 vs 90.8% (87.9-93.8); n = 290] and after 5 years [91.4% (89.2-93.8); n = 357 vs 70.9% (65.2-77.1); n = 106; P < 0.0001]. PPI use was also associated with improved PFS vs no PPI use after 1 year [95.9% (94.6-97.3); n = 745 vs 86.4% (82.9-90.1); n = 278] and after 5 years [66.8% (63.0-70.8); n = 286 vs 45.9% (39.6-53.2); n = 69; P < 0.0001].

CONCLUSION: GERD had no effect on survival in SSc or SSc-ILD. PPIs improved survival in patients with SSc-ILD. Controlled, prospective trials are needed to confirm this finding.

Details

OriginalspracheEnglisch
Seiten (von - bis)3067-3074
Seitenumfang8
FachzeitschriftRheumatology
Jahrgang62
Ausgabenummer9
PublikationsstatusVeröffentlicht - 1 Sept. 2023
Peer-Review-StatusJa

Externe IDs

PubMedCentral PMC10473195
Scopus 85169504430
ORCID /0000-0002-4330-1861/work/151982024

Schlagworte

Schlagwörter

  • Gastroesophageal Reflux/complications, Humans, Lung, Lung Diseases, Interstitial/etiology, Prospective Studies, Proton Pump Inhibitors/therapeutic use, Retrospective Studies, Scleroderma, Systemic/complications