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New model effectively predicts mortality in RA‐ILD patients

01 Dec 2020

A risk prediction model based on high-resolution computed tomography (HRCT) variables appear useful for patients with rheumatoid arthritis (RA)-associated interstitial lung disease (ILD), suggests a study.

Retrospective data from 153 patients with RA-ILD were used to develop the prediction model, which was validated in an independent RA-ILD cohort (n=149). The authors screened candidate variables for the prediction models using a multivariate Cox proportional hazard model and calculated C-statistics to assess and compare the predictive ability of each model.

Over a median follow-up period of 54 months, 38.6 percent of patients in the derivation cohort showed a usual interstitial pneumonia (UIP) pattern on HRCT imaging. Multivariate Cox analysis revealed the following HRCT factors associated with poor prognosis that were included in the final model: old age (≥60 years; hazard ratio [HR], 2.063), high fibrosis score (≥20 percent of the total lung extent; HR, 4.585), a UIP pattern (HR, 1.899), and emphysema (HR, 2.596).

The prediction model demonstrated good performance in predicting 5-year mortality (C-index, 0.780; p<0.001). At-risk patients were further divided into three groups with 1-year mortality rates of 0 percent, 5.1 percent, and 24.1 percent, respectively.

Predicted and observed mortalities were similar at 1, 2, and 3 years in the derivation cohort. In addition, the prediction model effectively predicted prognosis of the validation cohort (C-index, 0.638; p<0.001).

“RA‐ILD has a variable clinical course, and its prognosis is difficult to predict. Moreover, risk prediction models for prognosis remain undefined,” the authors said.

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Most Read Articles
Audrey Abella, 03 Aug 2020
Adding the anti-GM-CSF* receptor-α monoclonal antibody mavrilimumab to standard care (SC) improved clinical outcomes in patients with severe coronavirus disease 2019 (COVID-19) pneumonia and systemic hyperinflammation who were not under mechanical ventilation (MV), an Italian study has shown.
Pearl Toh, 08 Dec 2020
Intravenous (IV) antibiotics are no better than oral antibiotics when it comes to eradicating Pseudomonas (P.) aeruginosa in children and adults with cystic fibrosis, yet are more costly than the latter, reveals the TORPEDO-CF study.
Rachel Soon, 05 Dec 2020

The Malaysian National Immunisation Programme (NIP) will now include a hexavalent combination DTaP-IPV-HiB-HepB vaccine and a pneumococcal vaccine.

Elvira Manzano, 12 Dec 2020
Having asthma or allergy does not make COVID-19 severe, a new study presented at ACAAI 2020 has shown.