Sex influence on outcomes of patients with systemic sclerosis-associated interstitial lung disease: a EUSTAR database analysis.

Campochiaro C, Hoffmann-Vold AM, Avouac J, Henes J, de Vries-Bouwstra J, Smith V, Siegert E, Airò P, Oksel F, Pellerito R, Vanthuyne M, Pozzi MR, Inanc M, Sibilia J, Gabrielli A, Distler O, Allanore Y (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Book Volume: 62

Pages Range: 2483-2491

Journal Issue: 7

DOI: 10.1093/rheumatology/keac660

Abstract

OBJECTIVE: Interstitial lung disease (ILD) is the leading cause of morbidity and mortality in systemic sclerosis (SSc) patients. We aimed to investigate the impact of sex on SSc-ILD. METHODS: EUSTAR SSc patients with radiologically confirmed ILD and available percentage predicted forced vital capacity (%pFVC) were included. Demographics and disease features were recorded. A change in %pFVC over 12 months (s.d. 6) (cohort 1) was classified into stable (≤4%), mild (5-9%) and large progression (≥10%). In those with 2-year longitudinal %pFVC (cohort 2), the %pFVC change at each 12-month (s.d. 6) interval was calculated. Logistic regression analyses [odds ratio (OR) and 95% CI] and Cox proportional hazards models adjusted for age and %pFVC were applied. RESULTS: A total of 1136 male and 5253 female SSc-ILD patients were identified. Males were significantly younger, had a shorter disease duration, had a higher prevalence of CRP elevation and frequently had diffuse cutaneous involvement. In cohort 1 (1655 females and 390 males), a higher percentage of males had stable ILD (74.4% vs 69.4%, P = 0.056). In multivariable analysis, disease duration and %pFVC [OR 0.99 (95% CI 0.98, 0.99) and OR 0.97 (95% CI 0.95, 0.99), respectively] in males and age, %pFVC and anti-centromere [OR 1.02 (95% CI 1.00, 1.04), OR 0.97 (95% CI 0.96, 0.98) and OR 0.39 (95% CI 0.245, 0.63), respectively] in females were associated with large progression. The 1-year mortality rate was higher in males (5.1% vs 2.5%, P = 0.013). In cohort 2 (849 females and 209 males), a higher percentage of females showed periods of large progression (11.7% vs 7.7%, P = 0.023), the percentage of patients with none, one or two periods of worsening was not different. The overall death rate was 30.9% for males and 20.4% in females (P < 0.001). In the survival analysis, male sex was a predictor of mortality [OR 1.95 (95% CI 1.66, 2.28)]. CONCLUSIONS: Male SSc-ILD patients have a poorer prognosis and sex-specific predictors exist in SSc-ILD.

Involved external institutions

Università Vita-Salute San Raffaele (UniSR) Italy (IT) Oslo University Hospital / Oslo Universitetssykehus Rikshospitalet Norway (NO) Assistance Publique-Hôpitaux de Paris (AP-HP) France (FR) Universitätsklinikum Tübingen Germany (DE) Leiden University Medical Center Netherlands (NL) Istanbul University / İstanbul Üniversitesi Turkey (TR) University Hospital Ghent Belgium (BE) Charité - Universitätsmedizin Berlin Germany (DE) Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia Italy (IT) Ege University / Ege Üniversitesi Turkey (TR) L'Ospedale Mauriziano di Torino Italy (IT) Cliniques universitaires Saint-Luc (CHU St-Luc) Belgium (BE) Azienda Ospedaliera San Gerardo (ASST Monza) Italy (IT) Hôpital de Hautepierre France (FR) Università Politecnica delle Marche (UNIVPM) / Marche Polytechnic University Italy (IT) Universitätsspital Zürich (USZ) Switzerland (CH)

How to cite

APA:

Campochiaro, C., Hoffmann-Vold, A.M., Avouac, J., Henes, J., de Vries-Bouwstra, J., Smith, V.,... Allanore, Y. (2023). Sex influence on outcomes of patients with systemic sclerosis-associated interstitial lung disease: a EUSTAR database analysis. Rheumatology, 62(7), 2483-2491. https://dx.doi.org/10.1093/rheumatology/keac660

MLA:

Campochiaro, Corrado, et al. "Sex influence on outcomes of patients with systemic sclerosis-associated interstitial lung disease: a EUSTAR database analysis." Rheumatology 62.7 (2023): 2483-2491.

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