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Are risk predicting models useful for estimating survival in rheumatoid arthritis-associated interstitial lung disease?

Hanna Nurmi, Minna Purokivi, Miia Kärkkäinen, Hannu-Pekka Kettunen, Tuomas Selander, Riitta Kaarteenaho
European Respiratory Journal 2016 48: PA4885; DOI: 10.1183/13993003.congress-2016.PA4885
Hanna Nurmi
1Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland
2Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Minna Purokivi
1Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland
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Miia Kärkkäinen
2Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
4Harjula Hospital, the Muncipal Hospital of Kuopio, Kuopio, Finland
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Hannu-Pekka Kettunen
5Diagnostic Imaging Center, Division of Radiology, Kuopio University Hospital, Kuopio, Finland
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Tuomas Selander
6Science Services Center, Kuopio University Hospital, Kuopio, Finland
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Riitta Kaarteenaho
1Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland
2Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
3Respiratory Medicine, Internal Medicine Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Abstract

Risk predicting models have been applied in idiopathic pulmonary fibrosis (IPF), but not yet validated in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD). The purpose of this study was to test the suitability of three prediction models as well as individual lung function and demographic factors for estimating prognosis of the RA-ILD patients.

Clinical and radiological data of 59 RA-ILD patients was re-assessed. GAP (gender, age, physiologic variables) and the modified interstitial lung disease (ILD)-GAP indexes as well as the composite physiologic index (CPI) were tested for predicting mortality using the goodness-of-fit test and Cox model. Potential predictors of mortality were searched also among single lung function parameters and clinical characteristics.

The median survival was 152 months in GAP stage I and 61 months in GAP stage II (p=0.017). Both the GAP model and ILD-GAP model produced accurate estimates of the 1-year, 2-year and 3-year mortality. CPI (p=0.025), GAP (p=0.008) and ILD-GAP (p=0.028) scores, age (p=0.002), baseline diffusion capacity to carbon monoxide (DLCO) (p= 0.014) and hospitalization due to respiratory reasons (p=0.039) were significant predictors of mortality in univariate analysis. The CPI score (HR 1.03, p=0.018) and baseline DLCO (HR 0.97, p=0.011) remained significant predictors of mortality after adjusting for age.

We conclude that the GAP and ILD-GAP are applicable in RA-ILD risk estimation in a similar manner than in IPF. Baseline DLCO and CPI score predicted also survival.

  • Interstitial lung disease (connective tissue disease)
  • Lung function testing
  • Copyright ©the authors 2016
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Are risk predicting models useful for estimating survival in rheumatoid arthritis-associated interstitial lung disease?
Hanna Nurmi, Minna Purokivi, Miia Kärkkäinen, Hannu-Pekka Kettunen, Tuomas Selander, Riitta Kaarteenaho
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4885; DOI: 10.1183/13993003.congress-2016.PA4885

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Are risk predicting models useful for estimating survival in rheumatoid arthritis-associated interstitial lung disease?
Hanna Nurmi, Minna Purokivi, Miia Kärkkäinen, Hannu-Pekka Kettunen, Tuomas Selander, Riitta Kaarteenaho
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4885; DOI: 10.1183/13993003.congress-2016.PA4885
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