Abstract
Introduction: As fibrosing ILDs (fILD) are associated with high mortality, monitoring of response to therapy is highly clinically relevant. KL-6 was mainly investigated in Asia and shown to be associated with the presence and severity of different fILDs. Our aim was to evaluate KL-6 as a therapeutic biomarker in fILD in European patients.
Methods: Consecutive patients with fILD were recruited prospectively and serum concentrations of KL-6 determined at baseline (BL) and at 6 months intervals up to 12 months (6M, 12M). Clinical characteristics including lung function tests and treatments were assessed at the 6 monthly visits and correlated to KL-6 values.
Results: 47 fILD patients were recruited (mean age: 69, 68% male, IPF n=12; non-IPF n=35). KL-6 levels were significantly higher in ILD than in healthy controls (n=44, mean age: 50, 23% male): (ILD: 1757±1960 vs. control: 265±107 mean U/ml, p<0.001). However, no difference was noted between ILD subgroups. While KL-6 decreased significantly under therapy (6M∆BL-KL6: -486±1505 mean U/ml, p=0.03; 12M∆BL-KL6: -547±1782 mean U/ml, p=0.04), there was no association between changes of KL-6 and progression free survival (death, FVC decline ≥10% or DLCO decline ≥15%, p=0.9). In patients with an FVC increase ≥10% under therapy, a significant decrease of KL-6 (6M∆BL-KL6: -1704±2482 mean U/ml, p=0.03; 12M∆BL-KL6: -2061±2877 mean U/ml, p=0.02) was noted while there was only a trend in change for FVC decline.
Conclusion: A decline of KL-6 under therapy correlated with clinically relevant improvements of lung function. Thus, KL-6 might serve as a therapeutic biomarker, which however has to be determined by larger prospective cohorts.
Footnotes
Cite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 820.
This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2020