Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis
Abstract Objectives Gastroesophageal reflux disease (GERD) occurs frequently in patients with SSc. We investigated whether the presence of GERD and/or the use of anti-acid therapy, specifically proton-pump inhibitors (PPIs), are associated with long-term outcomes, especially in SSc-associated inters...
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| Veröffentlicht in: | Rheumatology (Oxford, England) England), 2023-09, Vol.62 (9), p.3067-3074 |
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| creator | Kreuter, Michael Bonella, Francesco Blank, Norbert Riemekasten, Gabriela Müller-Ladner, Ulf Henes, Jörg Siegert, Elise Günther, Claudia Kötter, Ina Pfeiffer, Christiane Schmalzing, Marc Zeidler, Gabriele Korsten, Peter Susok, Laura Juche, Aaron Worm, Margitta Jandova, Ilona Ehrchen, Jan Sunderkötter, Cord Keyßer, Gernot Ramming, Andreas Schmeiser, Tim Kreuter, Alexander Kuhr, Kathrin Lorenz, Hanns-Martin Moinzadeh, Pia Hunzelmann, Nicolas |
| description | Abstract
Objectives
Gastroesophageal reflux disease (GERD) occurs frequently in patients with SSc. We investigated whether the presence of GERD and/or the use of anti-acid therapy, specifically proton-pump inhibitors (PPIs), are associated with long-term outcomes, especially in SSc-associated interstitial lung disease (SSc-ILD).
Methods
We retrospectively analysed patients with SSc and SSc-ILD from the German Network for Systemic Sclerosis (DNSS) database (2003 onwards). Kaplan–Meier analysis compared overall survival (OS) and progression-free survival (PFS) in patients with GERD vs without GERD (SSc and SSc-ILD), and PPI vs no PPI use (SSc-ILD only). Progression was defined as a decrease in either percentage predicted forced vital capacity of ≥10% or single-breath diffusing capacity for carbon monoxide of ≥15%, or death.
Results
It was found that 2693/4306 (63%) registered patients with SSc and 1204/1931 (62%) with SSc-ILD had GERD. GERD was not associated with decreased OS or decreased PFS in patients in either cohort. In SSc-ILD, PPI use was associated with improved OS vs no PPI use after 1 year [98.4% (95% CI: 97.6, 99.3); n = 760 vs 90.8% (87.9–93.8); n = 290] and after 5 years [91.4% (89.2–93.8); n = 357 vs 70.9% (65.2–77.1); n = 106; P |
| doi_str_mv | 10.1093/rheumatology/kead023 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10473195</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/rheumatology/kead023</oup_id><sourcerecordid>2770479419</sourcerecordid><originalsourceid>FETCH-LOGICAL-c449t-821aa54d95a942f1385d662ec7f698fdd323ca3181c19b8e48a2bc7783efafc43</originalsourceid><addsrcrecordid>eNqNkU1v1DAQhiMEoqXwDxDykUu6_kpic0FV1RakqhwWztasPdk1TeLFdkB746fX1S6rcuvJ1swzjz16q-o9o-eMarGIG5xHyGEI693iHsFRLl5Up0y2vKZC8JfHO5cn1ZuUflJKGybU6-pEtB1VlKrT6u_FlH0N1juSNxhhuyN-IsulrSGlYD1kdKWSMabss4eBDPO0Js4nhISfyBCmdV26IwlztmHERPoYxkcZuSllmMgd5j8h3pM-RLLcpYyjt2RpB4wh-fS2etXDkPDd4Tyrflxffb_8Ut9-u_l6eXFbWyl1rhVnAI10ugEteV_WaFzbcrRd32rVOye4sCCYYpbplUKpgK9s1ymBPfRWirPq8967nVcjOotTjjCYbfQjxJ0J4M3_nclvzDr8NozKTjDdFMPHgyGGXzOmbEafLA4DTBjmZHjXFVRLpgsq96gtO6aI_fEdRs1jeuZpeuaQXhn78PSPx6F_cRVgsQfCvH2e8gHalbAF</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2770479419</pqid></control><display><type>article</type><title>Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Kreuter, Michael ; Bonella, Francesco ; Blank, Norbert ; Riemekasten, Gabriela ; Müller-Ladner, Ulf ; Henes, Jörg ; Siegert, Elise ; Günther, Claudia ; Kötter, Ina ; Pfeiffer, Christiane ; Schmalzing, Marc ; Zeidler, Gabriele ; Korsten, Peter ; Susok, Laura ; Juche, Aaron ; Worm, Margitta ; Jandova, Ilona ; Ehrchen, Jan ; Sunderkötter, Cord ; Keyßer, Gernot ; Ramming, Andreas ; Schmeiser, Tim ; Kreuter, Alexander ; Kuhr, Kathrin ; Lorenz, Hanns-Martin ; Moinzadeh, Pia ; Hunzelmann, Nicolas</creator><creatorcontrib>Kreuter, Michael ; Bonella, Francesco ; Blank, Norbert ; Riemekasten, Gabriela ; Müller-Ladner, Ulf ; Henes, Jörg ; Siegert, Elise ; Günther, Claudia ; Kötter, Ina ; Pfeiffer, Christiane ; Schmalzing, Marc ; Zeidler, Gabriele ; Korsten, Peter ; Susok, Laura ; Juche, Aaron ; Worm, Margitta ; Jandova, Ilona ; Ehrchen, Jan ; Sunderkötter, Cord ; Keyßer, Gernot ; Ramming, Andreas ; Schmeiser, Tim ; Kreuter, Alexander ; Kuhr, Kathrin ; Lorenz, Hanns-Martin ; Moinzadeh, Pia ; Hunzelmann, Nicolas</creatorcontrib><description>Abstract
Objectives
Gastroesophageal reflux disease (GERD) occurs frequently in patients with SSc. We investigated whether the presence of GERD and/or the use of anti-acid therapy, specifically proton-pump inhibitors (PPIs), are associated with long-term outcomes, especially in SSc-associated interstitial lung disease (SSc-ILD).
Methods
We retrospectively analysed patients with SSc and SSc-ILD from the German Network for Systemic Sclerosis (DNSS) database (2003 onwards). Kaplan–Meier analysis compared overall survival (OS) and progression-free survival (PFS) in patients with GERD vs without GERD (SSc and SSc-ILD), and PPI vs no PPI use (SSc-ILD only). Progression was defined as a decrease in either percentage predicted forced vital capacity of ≥10% or single-breath diffusing capacity for carbon monoxide of ≥15%, or death.
Results
It was found that 2693/4306 (63%) registered patients with SSc and 1204/1931 (62%) with SSc-ILD had GERD. GERD was not associated with decreased OS or decreased PFS in patients in either cohort. In SSc-ILD, PPI use was associated with improved OS vs no PPI use after 1 year [98.4% (95% CI: 97.6, 99.3); n = 760 vs 90.8% (87.9–93.8); n = 290] and after 5 years [91.4% (89.2–93.8); n = 357 vs 70.9% (65.2–77.1); n = 106; P < 0.0001]. PPI use was also associated with improved PFS vs no PPI use after 1 year [95.9% (94.6–97.3); n = 745 vs 86.4% (82.9–90.1); n = 278] and after 5 years [66.8% (63.0–70.8); n = 286 vs 45.9% (39.6–53.2); n = 69; P < 0.0001].
Conclusion
GERD had no effect on survival in SSc or SSc-ILD. PPIs improved survival in patients with SSc-ILD. Controlled, prospective trials are needed to confirm this finding.</description><identifier>ISSN: 1462-0324</identifier><identifier>EISSN: 1462-0332</identifier><identifier>DOI: 10.1093/rheumatology/kead023</identifier><identifier>PMID: 36708008</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Clinical Science</subject><ispartof>Rheumatology (Oxford, England), 2023-09, Vol.62 (9), p.3067-3074</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c449t-821aa54d95a942f1385d662ec7f698fdd323ca3181c19b8e48a2bc7783efafc43</citedby><cites>FETCH-LOGICAL-c449t-821aa54d95a942f1385d662ec7f698fdd323ca3181c19b8e48a2bc7783efafc43</cites><orcidid>0000-0001-6065-5680 ; 0000-0003-4402-2159 ; 0000-0001-7680-9971 ; 0000-0002-9419-1690 ; 0000-0001-5940-3195</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36708008$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kreuter, Michael</creatorcontrib><creatorcontrib>Bonella, Francesco</creatorcontrib><creatorcontrib>Blank, Norbert</creatorcontrib><creatorcontrib>Riemekasten, Gabriela</creatorcontrib><creatorcontrib>Müller-Ladner, Ulf</creatorcontrib><creatorcontrib>Henes, Jörg</creatorcontrib><creatorcontrib>Siegert, Elise</creatorcontrib><creatorcontrib>Günther, Claudia</creatorcontrib><creatorcontrib>Kötter, Ina</creatorcontrib><creatorcontrib>Pfeiffer, Christiane</creatorcontrib><creatorcontrib>Schmalzing, Marc</creatorcontrib><creatorcontrib>Zeidler, Gabriele</creatorcontrib><creatorcontrib>Korsten, Peter</creatorcontrib><creatorcontrib>Susok, Laura</creatorcontrib><creatorcontrib>Juche, Aaron</creatorcontrib><creatorcontrib>Worm, Margitta</creatorcontrib><creatorcontrib>Jandova, Ilona</creatorcontrib><creatorcontrib>Ehrchen, Jan</creatorcontrib><creatorcontrib>Sunderkötter, Cord</creatorcontrib><creatorcontrib>Keyßer, Gernot</creatorcontrib><creatorcontrib>Ramming, Andreas</creatorcontrib><creatorcontrib>Schmeiser, Tim</creatorcontrib><creatorcontrib>Kreuter, Alexander</creatorcontrib><creatorcontrib>Kuhr, Kathrin</creatorcontrib><creatorcontrib>Lorenz, Hanns-Martin</creatorcontrib><creatorcontrib>Moinzadeh, Pia</creatorcontrib><creatorcontrib>Hunzelmann, Nicolas</creatorcontrib><title>Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis</title><title>Rheumatology (Oxford, England)</title><addtitle>Rheumatology (Oxford)</addtitle><description>Abstract
Objectives
Gastroesophageal reflux disease (GERD) occurs frequently in patients with SSc. We investigated whether the presence of GERD and/or the use of anti-acid therapy, specifically proton-pump inhibitors (PPIs), are associated with long-term outcomes, especially in SSc-associated interstitial lung disease (SSc-ILD).
Methods
We retrospectively analysed patients with SSc and SSc-ILD from the German Network for Systemic Sclerosis (DNSS) database (2003 onwards). Kaplan–Meier analysis compared overall survival (OS) and progression-free survival (PFS) in patients with GERD vs without GERD (SSc and SSc-ILD), and PPI vs no PPI use (SSc-ILD only). Progression was defined as a decrease in either percentage predicted forced vital capacity of ≥10% or single-breath diffusing capacity for carbon monoxide of ≥15%, or death.
Results
It was found that 2693/4306 (63%) registered patients with SSc and 1204/1931 (62%) with SSc-ILD had GERD. GERD was not associated with decreased OS or decreased PFS in patients in either cohort. In SSc-ILD, PPI use was associated with improved OS vs no PPI use after 1 year [98.4% (95% CI: 97.6, 99.3); n = 760 vs 90.8% (87.9–93.8); n = 290] and after 5 years [91.4% (89.2–93.8); n = 357 vs 70.9% (65.2–77.1); n = 106; P < 0.0001]. PPI use was also associated with improved PFS vs no PPI use after 1 year [95.9% (94.6–97.3); n = 745 vs 86.4% (82.9–90.1); n = 278] and after 5 years [66.8% (63.0–70.8); n = 286 vs 45.9% (39.6–53.2); n = 69; P < 0.0001].
Conclusion
GERD had no effect on survival in SSc or SSc-ILD. PPIs improved survival in patients with SSc-ILD. Controlled, prospective trials are needed to confirm this finding.</description><subject>Clinical Science</subject><issn>1462-0324</issn><issn>1462-0332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqNkU1v1DAQhiMEoqXwDxDykUu6_kpic0FV1RakqhwWztasPdk1TeLFdkB746fX1S6rcuvJ1swzjz16q-o9o-eMarGIG5xHyGEI693iHsFRLl5Up0y2vKZC8JfHO5cn1ZuUflJKGybU6-pEtB1VlKrT6u_FlH0N1juSNxhhuyN-IsulrSGlYD1kdKWSMabss4eBDPO0Js4nhISfyBCmdV26IwlztmHERPoYxkcZuSllmMgd5j8h3pM-RLLcpYyjt2RpB4wh-fS2etXDkPDd4Tyrflxffb_8Ut9-u_l6eXFbWyl1rhVnAI10ugEteV_WaFzbcrRd32rVOye4sCCYYpbplUKpgK9s1ymBPfRWirPq8967nVcjOotTjjCYbfQjxJ0J4M3_nclvzDr8NozKTjDdFMPHgyGGXzOmbEafLA4DTBjmZHjXFVRLpgsq96gtO6aI_fEdRs1jeuZpeuaQXhn78PSPx6F_cRVgsQfCvH2e8gHalbAF</recordid><startdate>20230901</startdate><enddate>20230901</enddate><creator>Kreuter, Michael</creator><creator>Bonella, Francesco</creator><creator>Blank, Norbert</creator><creator>Riemekasten, Gabriela</creator><creator>Müller-Ladner, Ulf</creator><creator>Henes, Jörg</creator><creator>Siegert, Elise</creator><creator>Günther, Claudia</creator><creator>Kötter, Ina</creator><creator>Pfeiffer, Christiane</creator><creator>Schmalzing, Marc</creator><creator>Zeidler, Gabriele</creator><creator>Korsten, Peter</creator><creator>Susok, Laura</creator><creator>Juche, Aaron</creator><creator>Worm, Margitta</creator><creator>Jandova, Ilona</creator><creator>Ehrchen, Jan</creator><creator>Sunderkötter, Cord</creator><creator>Keyßer, Gernot</creator><creator>Ramming, Andreas</creator><creator>Schmeiser, Tim</creator><creator>Kreuter, Alexander</creator><creator>Kuhr, Kathrin</creator><creator>Lorenz, Hanns-Martin</creator><creator>Moinzadeh, Pia</creator><creator>Hunzelmann, Nicolas</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6065-5680</orcidid><orcidid>https://orcid.org/0000-0003-4402-2159</orcidid><orcidid>https://orcid.org/0000-0001-7680-9971</orcidid><orcidid>https://orcid.org/0000-0002-9419-1690</orcidid><orcidid>https://orcid.org/0000-0001-5940-3195</orcidid></search><sort><creationdate>20230901</creationdate><title>Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis</title><author>Kreuter, Michael ; Bonella, Francesco ; Blank, Norbert ; Riemekasten, Gabriela ; Müller-Ladner, Ulf ; Henes, Jörg ; Siegert, Elise ; Günther, Claudia ; Kötter, Ina ; Pfeiffer, Christiane ; Schmalzing, Marc ; Zeidler, Gabriele ; Korsten, Peter ; Susok, Laura ; Juche, Aaron ; Worm, Margitta ; Jandova, Ilona ; Ehrchen, Jan ; Sunderkötter, Cord ; Keyßer, Gernot ; Ramming, Andreas ; Schmeiser, Tim ; Kreuter, Alexander ; Kuhr, Kathrin ; Lorenz, Hanns-Martin ; Moinzadeh, Pia ; Hunzelmann, Nicolas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c449t-821aa54d95a942f1385d662ec7f698fdd323ca3181c19b8e48a2bc7783efafc43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Clinical Science</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kreuter, Michael</creatorcontrib><creatorcontrib>Bonella, Francesco</creatorcontrib><creatorcontrib>Blank, Norbert</creatorcontrib><creatorcontrib>Riemekasten, Gabriela</creatorcontrib><creatorcontrib>Müller-Ladner, Ulf</creatorcontrib><creatorcontrib>Henes, Jörg</creatorcontrib><creatorcontrib>Siegert, Elise</creatorcontrib><creatorcontrib>Günther, Claudia</creatorcontrib><creatorcontrib>Kötter, Ina</creatorcontrib><creatorcontrib>Pfeiffer, Christiane</creatorcontrib><creatorcontrib>Schmalzing, Marc</creatorcontrib><creatorcontrib>Zeidler, Gabriele</creatorcontrib><creatorcontrib>Korsten, Peter</creatorcontrib><creatorcontrib>Susok, Laura</creatorcontrib><creatorcontrib>Juche, Aaron</creatorcontrib><creatorcontrib>Worm, Margitta</creatorcontrib><creatorcontrib>Jandova, Ilona</creatorcontrib><creatorcontrib>Ehrchen, Jan</creatorcontrib><creatorcontrib>Sunderkötter, Cord</creatorcontrib><creatorcontrib>Keyßer, Gernot</creatorcontrib><creatorcontrib>Ramming, Andreas</creatorcontrib><creatorcontrib>Schmeiser, Tim</creatorcontrib><creatorcontrib>Kreuter, Alexander</creatorcontrib><creatorcontrib>Kuhr, Kathrin</creatorcontrib><creatorcontrib>Lorenz, Hanns-Martin</creatorcontrib><creatorcontrib>Moinzadeh, Pia</creatorcontrib><creatorcontrib>Hunzelmann, Nicolas</creatorcontrib><collection>Oxford Academic Journals (Open Access)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Rheumatology (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kreuter, Michael</au><au>Bonella, Francesco</au><au>Blank, Norbert</au><au>Riemekasten, Gabriela</au><au>Müller-Ladner, Ulf</au><au>Henes, Jörg</au><au>Siegert, Elise</au><au>Günther, Claudia</au><au>Kötter, Ina</au><au>Pfeiffer, Christiane</au><au>Schmalzing, Marc</au><au>Zeidler, Gabriele</au><au>Korsten, Peter</au><au>Susok, Laura</au><au>Juche, Aaron</au><au>Worm, Margitta</au><au>Jandova, Ilona</au><au>Ehrchen, Jan</au><au>Sunderkötter, Cord</au><au>Keyßer, Gernot</au><au>Ramming, Andreas</au><au>Schmeiser, Tim</au><au>Kreuter, Alexander</au><au>Kuhr, Kathrin</au><au>Lorenz, Hanns-Martin</au><au>Moinzadeh, Pia</au><au>Hunzelmann, Nicolas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis</atitle><jtitle>Rheumatology (Oxford, England)</jtitle><addtitle>Rheumatology (Oxford)</addtitle><date>2023-09-01</date><risdate>2023</risdate><volume>62</volume><issue>9</issue><spage>3067</spage><epage>3074</epage><pages>3067-3074</pages><issn>1462-0324</issn><eissn>1462-0332</eissn><abstract>Abstract
Objectives
Gastroesophageal reflux disease (GERD) occurs frequently in patients with SSc. We investigated whether the presence of GERD and/or the use of anti-acid therapy, specifically proton-pump inhibitors (PPIs), are associated with long-term outcomes, especially in SSc-associated interstitial lung disease (SSc-ILD).
Methods
We retrospectively analysed patients with SSc and SSc-ILD from the German Network for Systemic Sclerosis (DNSS) database (2003 onwards). Kaplan–Meier analysis compared overall survival (OS) and progression-free survival (PFS) in patients with GERD vs without GERD (SSc and SSc-ILD), and PPI vs no PPI use (SSc-ILD only). Progression was defined as a decrease in either percentage predicted forced vital capacity of ≥10% or single-breath diffusing capacity for carbon monoxide of ≥15%, or death.
Results
It was found that 2693/4306 (63%) registered patients with SSc and 1204/1931 (62%) with SSc-ILD had GERD. GERD was not associated with decreased OS or decreased PFS in patients in either cohort. In SSc-ILD, PPI use was associated with improved OS vs no PPI use after 1 year [98.4% (95% CI: 97.6, 99.3); n = 760 vs 90.8% (87.9–93.8); n = 290] and after 5 years [91.4% (89.2–93.8); n = 357 vs 70.9% (65.2–77.1); n = 106; P < 0.0001]. PPI use was also associated with improved PFS vs no PPI use after 1 year [95.9% (94.6–97.3); n = 745 vs 86.4% (82.9–90.1); n = 278] and after 5 years [66.8% (63.0–70.8); n = 286 vs 45.9% (39.6–53.2); n = 69; P < 0.0001].
Conclusion
GERD had no effect on survival in SSc or SSc-ILD. PPIs improved survival in patients with SSc-ILD. Controlled, prospective trials are needed to confirm this finding.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>36708008</pmid><doi>10.1093/rheumatology/kead023</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6065-5680</orcidid><orcidid>https://orcid.org/0000-0003-4402-2159</orcidid><orcidid>https://orcid.org/0000-0001-7680-9971</orcidid><orcidid>https://orcid.org/0000-0002-9419-1690</orcidid><orcidid>https://orcid.org/0000-0001-5940-3195</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Clinical Science |
| title | Anti-acid therapy in SSc-associated interstitial lung disease: long-term outcomes from the German Network for Systemic Sclerosis |
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