Annual variation rate of KL-6 for predicting acute exacerbation in patients with rheumatoid arthritis-associated interstitial lung disease

Tanaka, Nozomi; Nishimura, Keisuke; Waki, Daisuke; Kadoba, Keiichiro; Murabe, Hiroyuki; Yokota, Toshihiko

doi:10.1080/14397595.2021.1879346

Cited by 13 publications

(19 citation statements)

References 21 publications

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“…No eligible studies were identified by screening the references of eligible articles or related reviews. Six studies aimed to explore the risk factors of AE-RA-ILD in detail [ 28 – 33 ]. The remaining two studies addressed the relationship between the UIP pattern and AE-RA-ILD [ 34 , 35 ].…”

Section: Resultsmentioning

confidence: 99%

Incidence, risk factors, and prognosis of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis

Xie

Zhu

2023

BMC Pulm Med

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Introduction Acute exacerbation (AE) is a devastating complication of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and leads to high mortality. This study aimed to investigate the incidence, risk factors, and prognosis of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease (AE-RA-ILD). Methods PubMed, EMBASE, Web of Science, and Medline were searched through 8 February 2023. Two independent researchers selected eligible articles and extracted available data. The Newcastle Ottawa Scale was used to assess the methodological quality of studies used for meta-analysis. The incidence and prognosis of AE-RA-ILD were investigated. Weighted mean differences (WMDs) with corresponding 95% confidence intervals (CIs) and pooled odds ratios (ORs) with 95% CIs were calculated to explore the risk factors of AE in RA-ILD. Results Twenty-one of 1,589 articles were eligible. A total of 385 patients with AE-RA-ILD, of whom 53.5% were male, were included. The frequency of AE in patients with RA-ILD ranged from 6.3 to 55.6%. The 1-year and 5-year AE incidences were 2.6–11.1% and 11–29.4%, respectively. The all-cause mortality rate of AE-RA-ILD was 12.6–27.9% at 30 days and 16.7–48.3% at 90 days. Age at RA diagnosis (WMD: 3.61, 95% CI: 0.22–7.01), male sex (OR: 1.60, 95% CI:1.16–2.21), smoking (OR: 1.50, 95% CI: 1.08–2.08), lower forced vital capacity predicted (FVC%; WMD: −8.63, 95% CI: −14.68 to − 2.58), and definite usual interstitial pneumonia (UIP) pattern (OR: 1.92, 95% CI: 1.15–3.22) were the risk factors of AE-RA-ILD. Moreover, the use of corticosteroids, methotrexate, and biological disease-modifying anti-rheumatic drugs, was not associated with AE-RA-ILD. Conclusion AE-RA-ILD was not rare and had a poor prognosis. Age at RA diagnosis, male sex, smoking, lower FVC%, and definite UIP pattern increased the risk of AE-RA-ILD. The use of medications, especially methotrexate and biological disease-modifying anti-rheumatic drugs, may not be related to AE-RA-ILD. Registration CRD42023396772.

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Section: Resultsmentioning

confidence: 99%

Incidence, risk factors, and prognosis of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis

Xie

Zhu

2023

BMC Pulm Med

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“…In the case of MMP7, it may be considered in the context of a spectrum of biomarkers that could potentially be predictive. Several studies have examined soluble biomarkers such as Krebs von den Lungen 6 in RA-ILD, but almost all have compared markers in separate cohorts of patients with and without ILD 45–47 or have looked at the effect of biomarkers on outcome or severity of ILD 48 49 and do not provide information on markers in patients without ILD who subsequently develop ILD. Nevertheless, these robust data support associations of soluble biomarkers such as Krebs von den Lungen 6 and C reactive protein with ILD and represent a potentially important area for prediction of ILD.…”

Section: Discussionmentioning

confidence: 99%

Patient-level factors predictive of interstitial lung disease in rheumatoid arthritis: a systematic review

et al. 2023

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ObjectiveInterstitial lung disease (ILD) is an important cause of mortality in some patients with rheumatoid arthritis (RA). Patient-level factors may predict which patients with RA are at the highest risk of developing ILD and are therefore candidates for screening for this complication of the underlying disease.MethodsA systematic literature review was performed using PubMed, Embase and Scopus over a 10-year period up to July 2021. Publications reporting patient-level factors in patients with RA with and without ILD that were assessed before development of ILD (or were unchanged over time and therefore could be extrapolated to before development of ILD) were retrieved for assessment of evidence. Genetic variation inMUC5Band treatment with methotrexate were not included in the assessment of evidence because these factors have already been widely investigated for association with ILD.ResultsWe found consistent associations of age, sex, smoking status and autoantibodies with development of ILD. For biomarkers such as Krebs von den Lungen 6, which have been shown to be diagnostic for ILD, there were no publications meeting criteria for this study.ConclusionsThis analysis provides an initial step in the identification of patient-level factors for potential development of a risk algorithm to identify patients with RA who may be candidates for screening for ILD. The findings represent a useful basis for future research leading to an improved understanding of the disease course and improved care for patients with RA at risk of development and progression of ILD.

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“…19,20 KL-6 is being intensively investigated as a circulating biomarker in the context of ILD, 21,22 ILD associated with connective tissue diseases (CTD-ILD), 16,23,24 ILD associated with systemic sclerosis 19,25 and ILD associated with RA. 20,[26][27][28] In this study, we assessed the levels of KL-6 in 89 RA patients; 25 patients without ILD and 64 patients with ILD and evaluated the performance of KL-6 in diagnosis of ILD. Results revealed higher levels of serum KL-6 in RA patients with ILD compared to those without ILD.…”

Section: Discussionmentioning

confidence: 99%

Krebs von den Lungen‐6, a promising marker in evaluating the severity of interstitial lung disease in Egyptian rheumatoid arthritis patients

Hammoda¹,

Salah-ElDin²,

El-Gharbawy³

2021

EJI

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Krebs von den Lungen-6 (KL-6) is one of the mucins associated with interstitial lung disease. We aimed to assess the value of KL-6 as a marker for detecting the presence of interstitial lung disease in Egyptian rheumatoid arthritis patients and to evaluate its ability to assess severity in different grades of interstitial lung disease. The study included 89 rheumatoid arthritis patients; 64 patients with interstitial lung disease and 25 patients without interstitial lung disease. Serum levels of KL-6 were assessed using enzyme linked immunosorbent assay. Levels of KL-6 were higher in patients with interstitial lung disease compared to patients without interstitial lung disease (P< 0.001). KL-6 levels were significantly higher in grade 4 patients than those in grades 1 and 2. Also, KL-6 levels were significantly higher in grade 3 patients than those in grades 1 and 2. Kl-6 levels were also higher in grade 2 patients compared to grade 1 patients. Finally, no difference was observed between grade 4 patients and grade 3 patients. KL-6 levels were significantly higher in usual interstitial pneumonia pattern compared other patterns (P=0.015). In conclusion, KL-6 is a potential circulating biomarker that may have a substantial role in detecting the presence and evaluating the severity of interstitial lung disease among rheumatoid arthritis patients.

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Annual variation rate of KL-6 for predicting acute exacerbation in patients with rheumatoid arthritis-associated interstitial lung disease

Cited by 13 publications

References 21 publications

Incidence, risk factors, and prognosis of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis

Incidence, risk factors, and prognosis of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis

Patient-level factors predictive of interstitial lung disease in rheumatoid arthritis: a systematic review

Krebs von den Lungen‐6, a promising marker in evaluating the severity of interstitial lung disease in Egyptian rheumatoid arthritis patients

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