Gastroesophageal reflux disease is associated with a more severe interstitial lung disease in systemic sclerosis in the EUSTAR cohort

Roth E, Bruni C, Petelytska L, Becker MO, Dobrota R, Jordan S, Mihai C, Muraru S, Carreira PE, De Vries-Bouwstra J, Braun-Moscovici Y, Liakouli V, Moroncini G, Bergmann C, Mouthon L, Denton CP, De Santis M, Cauli A, Adler S, Bernardino V, Truchetet ME, Vonk M, Galdo FD, Hoffmann-Vold AM, Distler O, Elhai M (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Rheumatology Oxford University Press

Book Volume: 64

Pages Range: SI63-SI72

Journal Issue: SI

DOI: 10.1093/rheumatology/keaf016

Abstract

Objectives: Gastroesophageal reflux disease (GERD) is frequent in systemic sclerosis (SSc) and could predict progression of interstitial lung disease (ILD). We aimed to analyse (1) the prevalence of GERD among SSc-ILD patients, (2) its association with disease characteristics and (3) predictive factors for ILD progression in SSc-ILD patients with GERD. Methods: SSc patients from the EUSTAR database with ILD were included. GERD was labelled as present if reflux/dysphagia was reported at the baseline visit or before. Disease characteristics of patients with and without GERD were compared at baseline. ILD progression was defined as relative FVC decline ≥10% or relative FVC decline between 5–9% in association with relative DLCO decline of ≥15% over 12 ± 3 months of follow-up. Prognostic factors for ILD progression, overall survival and progression-free survival in SSc-ILD patients with GERD were tested by multivariable Cox regression. Results: A total of 5462 SSc-ILD patients were included, 4400 (80.6%) had GERD. Patients with GERD presented more frequently with diffuse cutaneous SSc (OR: 1.44 [1.22–1.69], P < 0.001) and more severe lung involvement with lower FVC (85.8 ± 22.1 vs 90.2 ± 20.1, P < 0.001), lower DLCO (60.8 ± 19.7 vs 65.3 ± 20.6, P < 0.001) and worse performance at the 6-min walking test. Female sex (HR: 1.39 [1.07–1.80], P ¼ 0.012) and older age (HR: 1.02 [1.01–1.03], P < 0.001) independently predicted ILD progression in SSc-ILD patients with GERD. Conclusion: SSc-ILD patients with GERD appear to suffer from a more severe SSc disease. In this population, female sex may be considered a risk factor for ILD progression.

Authors with CRIS profile

Christina Bergmann Department of Medicine 3 – Rheumatology and Immunology

Involved external institutions

Azienda Ospedaliera Universitaria di Cagliari IT Italy (IT) Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC) NL Netherlands (NL) Azienda Ospedaliero Universitaria Ospedali Riuniti Ancona IT Italy (IT) Universitätsspital Zürich (USZ) CH Switzerland (CH) Centre Hospitalier Universitaire de Bordeaux / CHU Bordeaux FR France (FR) University College London (UCL) GB United Kingdom (GB) Kantonsspital Aarau AG CH Switzerland (CH) Leiden University Medical Center NL Netherlands (NL) Humanitas Research Hospital / IRCCS Istituto Clinico Humanitas IT Italy (IT) Hôpital Cochin FR France (FR) Central Lisbon University Hospital Centre / Centro Hospitalar Universitário de Lisboa Central (CHULC) PT Portugal (PT) Technion - Israel Institute of Technology IL Israel (IL) Università degli studi della Campania Luigi Vanvitelli IT Italy (IT) University of Leeds GB United Kingdom (GB)

How to cite

APA:

Roth, E., Bruni, C., Petelytska, L., Becker, M.O., Dobrota, R., Jordan, S.,... Elhai, M. (2025). Gastroesophageal reflux disease is associated with a more severe interstitial lung disease in systemic sclerosis in the EUSTAR cohort. Rheumatology, 64(SI), SI63-SI72. https://doi.org/10.1093/rheumatology/keaf016

MLA:

Roth, Eliane, et al. "Gastroesophageal reflux disease is associated with a more severe interstitial lung disease in systemic sclerosis in the EUSTAR cohort." Rheumatology 64.SI (2025): SI63-SI72.

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