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

Kreuter M, Bonella F, Blank N, Riemekasten G, Mueller-Ladner U, Henes J, Siegert E, Guenther C, Koetter I, Pfeiffer C, Schmalzing M, Zeidler G, Korsten P, Susok L, Juche A, Worm M, Jandova I, Ehrchen J, Sunderkoetter C, Keysser G, Ramming A, Schmeiser T, Kreuter A, Kuhr K, Lorenz HM, Moinzadeh P, Hunzelmann N (2023)

Publication Type: Journal article

Publication year: 2023

Journal

DOI: 10.1093/rheumatology/kead023

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.

Authors with CRIS profile

Involved external institutions

Ruprecht-Karls-Universität Heidelberg Germany (DE) Universität Duisburg-Essen (UDE) Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Universität zu Lübeck Germany (DE) Kerckhoff-Klinik Germany (DE) Universitätsklinikum Tübingen Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Technische Universität Dresden Germany (DE) Universitätsklinikum Köln Germany (DE) Klinikum der Universität München (Großhadern und Innenstadt) Germany (DE) Universitätsklinikum Würzburg Germany (DE) Johanniter-Krankenhaus im Fläming Treuenbrietzen GmbH Germany (DE) Universitätsklinikum Göttingen Germany (DE) Katholisches Klinikum Bochum (St. Josef- und St. Elisabeth-Hospital gGmbH) Germany (DE) Immanuel Krankenhaus Berlin Germany (DE) Universitätsklinikum Freiburg Germany (DE) Universitätsklinikum Münster Germany (DE) Universitätsklinikum Halle (Saale) Germany (DE) Krankenhaus St. Josef Germany (DE) Universität Witten/Herdecke Germany (DE)

How to cite

APA:

Kreuter, M., Bonella, F., Blank, N., Riemekasten, G., Mueller-Ladner, U., Henes, J.,... Hunzelmann, N. (2023). Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis. Rheumatology. https://doi.org/10.1093/rheumatology/kead023

MLA:

Kreuter, Michael, et al. "Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis." Rheumatology (2023).

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