The Value of Biomarkers as Predictors of Outcome in Patients with Rheumatoid Arthritis-Associated Usual Interstitial Pneumonia.

Abstract

BACKGROUND:

Because of the highly variable clinical course of rheumatoid arthritis-associated usual interstitial pneumonia (RA-UIP), the prediction of patient prognosis is important.

OBJECTIVE:

The aim of this study was to investigate the role of blood biomarkers as prognostic predictors in the patients with RA-UIP.

METHODS:

The blood levels of biomarkers (Krebs von den Lungen-6 [KL-6], surfactant protein-A [SP-A], matrix metalloproteinase-7 [MMP-7], interleukin-6 [IL-6], and interleukin-32 [IL-32]) were retrospectively compared with the clinical courses of 62 patients with RA-UIP.

RESULTS:

The median follow-up period was 33.4 months. RA-UIP progressed in 15 patients (45.2%) during one year of follow-up. We found that KL-6 and IL-6 were significant predictors of short-term (1 year) prognosis. Multivariate logistic regression analysis showed that the odds ratio (OR) for KL-6 was 1.001 (95% confidence interval [CI]: 1.000-1.003, p = 0.077) and that the OR for IL-6 was 1.040 (95% CI: 1.002-1.080, p = 0.039) for short-term disease progression. The addition of KL-6 and IL-6 to the clinical parameters (concordance index [C-index]: 0.958, p = 0.053) predicted short-term disease progression better than the clinical parameter alone (C-index: 0.853). In addition, patients with high levels of KL-6 (≥933 U/mL) had shorter survival than those with low levels of KL-6 (<933 U/mL) (median survival: 51 vs. 96 months, p = 0.019).

CONCLUSIONS:

The results of this retrospective study suggested that KL-6 and IL-6 could be used as predictors of short-term disease progression. In addition, high levels of KL-6 could be used as a predictor of mortality. Additional studies involving a larger patient cohort are warranted.

• Authors: Young Seok Lee, Ho Cheol Kim, Bo Young Lee, Chang Keun Lee, Mi-Young Kim, Se Jin Jang, Hye Sun Lee, Jieun Moon, Thomas V Colby, Dong Soon Kim
• Journal: Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG (Sarcoidosis Vasc Diffuse Lung Dis) Vol. 33 Issue 3 Pg. 216-223 (Oct 07 2016) ISSN: 2532-179X [Electronic] Italy
• PMID: 27758986 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• IL6 protein, human
• Interleukin-6
• MUC1 protein, human
• Mucin-1

Topics

• Aged
• Arthritis, Rheumatoid (complications, diagnosis, mortality)
• Biomarkers (blood)
• Disease Progression
• Female
• Humans
• Interleukin-6 (blood)
• Kaplan-Meier Estimate
• Logistic Models
• Lung Diseases, Interstitial (blood, diagnosis, etiology, mortality)
• Male
• Middle Aged
• Mucin-1 (blood)
• Multivariate Analysis
• Odds Ratio
• Predictive Value of Tests
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Time Factors
• Up-Regulation