Factors affecting treatment outcome in patients with idiopathic nonspecific interstitial pneumonia: a nationwide cohort study

Sang Hoon Lee, Moo Suk Park, Song Yee Kim, Dong Soon Kim, Young Whan Kim, Man Pyo Chung, Soo Taek Uh, Choon Sik Park, Sung Woo Park, Sung Hwan Jeong, Yong Bum Park, Hong Lyeol Lee, Jong Wook Shin, Eun Joo Lee, Jin Hwa Lee, Yangin Jegal, Hyun Kyung Lee, Yong Hyun Kim, Jin Woo Song, Jong Sun Park

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: The effects of corticosteroid-based therapy in patients with idiopathic nonspecific interstitial pneumonia (iNSIP), and factors affecting treatment outcome, are not fully understood. We aimed to investigate the long-term treatment response and factors affecting the treatment outcome in iNSIP patients from a multi-center study in Korea.

METHODS: The Korean interstitial lung disease (ILD) Study Group surveyed ILD patients from 2003 to 2007. Patients were divided into two groups to compare the treatment response: response group (forced vital capacity (FVC) improves ≥10% after 1 year) and non-response group (FVC <10%). Factors affecting treatment response were evaluated by multivariate logistic regression analysis.

RESULTS: A total of 261 patients with iNSIP were enrolled, and 95 patients were followed-up for more than 1 year. Corticosteroid treatment was performed in 86 patients. The treatment group showed a significant improvement in lung function after 1-year: FVC, 10.0%; forced expiratory volume (FEV1), 9.8%; diffusing capacity of the lung for carbon monoxide (DLco), 8.4% (p < 0.001). Sero-negative anti-nuclear antibody (ANA) was significantly related with lung function improvement. Sero-positivity ANA was significantly lower in the response group (p = 0.013), compared to that in the non-response group. A shorter duration of respiratory symptoms at diagnosis was significantly associated with a good response to treatment (p = 0.018).

CONCLUSION: Treatment with corticosteroids and/or immunosuppressants improved lung function in iNSIP patients, which was more pronounced in sero-negative ANA and shorter symptom duration patients. These findings suggest that early treatment should be considered in iNSIP patients, even in an early disease stage.

Original languageEnglish
Number of pages1
JournalRespiratory Research
Volume18
Issue number1
DOIs
Publication statusPublished - 2017 Dec 6

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Idiopathic Interstitial Pneumonias
Cohort Studies
Vital Capacity
Anti-Idiotypic Antibodies
Adrenal Cortex Hormones
Therapeutics
Interstitial Lung Diseases
Lung
Lung Volume Measurements
Forced Expiratory Volume
Carbon Monoxide
Immunosuppressive Agents
Korea
Logistic Models

Keywords

  • Non-specific interstitial pneumonia
  • Pulmonary lung function
  • Treatment

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Factors affecting treatment outcome in patients with idiopathic nonspecific interstitial pneumonia : a nationwide cohort study. / Lee, Sang Hoon; Park, Moo Suk; Kim, Song Yee; Kim, Dong Soon; Kim, Young Whan; Chung, Man Pyo; Uh, Soo Taek; Park, Choon Sik; Park, Sung Woo; Jeong, Sung Hwan; Park, Yong Bum; Lee, Hong Lyeol; Shin, Jong Wook; Lee, Eun Joo; Lee, Jin Hwa; Jegal, Yangin; Lee, Hyun Kyung; Kim, Yong Hyun; Song, Jin Woo; Park, Jong Sun.

In: Respiratory Research, Vol. 18, No. 1, 06.12.2017.

Research output: Contribution to journalArticle

Lee, SH, Park, MS, Kim, SY, Kim, DS, Kim, YW, Chung, MP, Uh, ST, Park, CS, Park, SW, Jeong, SH, Park, YB, Lee, HL, Shin, JW, Lee, EJ, Lee, JH, Jegal, Y, Lee, HK, Kim, YH, Song, JW & Park, JS 2017, 'Factors affecting treatment outcome in patients with idiopathic nonspecific interstitial pneumonia: a nationwide cohort study', Respiratory Research, vol. 18, no. 1. https://doi.org/10.1186/s12931-017-0686-7
Lee, Sang Hoon ; Park, Moo Suk ; Kim, Song Yee ; Kim, Dong Soon ; Kim, Young Whan ; Chung, Man Pyo ; Uh, Soo Taek ; Park, Choon Sik ; Park, Sung Woo ; Jeong, Sung Hwan ; Park, Yong Bum ; Lee, Hong Lyeol ; Shin, Jong Wook ; Lee, Eun Joo ; Lee, Jin Hwa ; Jegal, Yangin ; Lee, Hyun Kyung ; Kim, Yong Hyun ; Song, Jin Woo ; Park, Jong Sun. / Factors affecting treatment outcome in patients with idiopathic nonspecific interstitial pneumonia : a nationwide cohort study. In: Respiratory Research. 2017 ; Vol. 18, No. 1.
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abstract = "BACKGROUND: The effects of corticosteroid-based therapy in patients with idiopathic nonspecific interstitial pneumonia (iNSIP), and factors affecting treatment outcome, are not fully understood. We aimed to investigate the long-term treatment response and factors affecting the treatment outcome in iNSIP patients from a multi-center study in Korea.METHODS: The Korean interstitial lung disease (ILD) Study Group surveyed ILD patients from 2003 to 2007. Patients were divided into two groups to compare the treatment response: response group (forced vital capacity (FVC) improves ≥10{\%} after 1 year) and non-response group (FVC <10{\%}). Factors affecting treatment response were evaluated by multivariate logistic regression analysis.RESULTS: A total of 261 patients with iNSIP were enrolled, and 95 patients were followed-up for more than 1 year. Corticosteroid treatment was performed in 86 patients. The treatment group showed a significant improvement in lung function after 1-year: FVC, 10.0{\%}; forced expiratory volume (FEV1), 9.8{\%}; diffusing capacity of the lung for carbon monoxide (DLco), 8.4{\%} (p < 0.001). Sero-negative anti-nuclear antibody (ANA) was significantly related with lung function improvement. Sero-positivity ANA was significantly lower in the response group (p = 0.013), compared to that in the non-response group. A shorter duration of respiratory symptoms at diagnosis was significantly associated with a good response to treatment (p = 0.018).CONCLUSION: Treatment with corticosteroids and/or immunosuppressants improved lung function in iNSIP patients, which was more pronounced in sero-negative ANA and shorter symptom duration patients. These findings suggest that early treatment should be considered in iNSIP patients, even in an early disease stage.",
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AU - Lee, Sang Hoon

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AU - Kim, Song Yee

AU - Kim, Dong Soon

AU - Kim, Young Whan

AU - Chung, Man Pyo

AU - Uh, Soo Taek

AU - Park, Choon Sik

AU - Park, Sung Woo

AU - Jeong, Sung Hwan

AU - Park, Yong Bum

AU - Lee, Hong Lyeol

AU - Shin, Jong Wook

AU - Lee, Eun Joo

AU - Lee, Jin Hwa

AU - Jegal, Yangin

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AU - Kim, Yong Hyun

AU - Song, Jin Woo

AU - Park, Jong Sun

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N2 - BACKGROUND: The effects of corticosteroid-based therapy in patients with idiopathic nonspecific interstitial pneumonia (iNSIP), and factors affecting treatment outcome, are not fully understood. We aimed to investigate the long-term treatment response and factors affecting the treatment outcome in iNSIP patients from a multi-center study in Korea.METHODS: The Korean interstitial lung disease (ILD) Study Group surveyed ILD patients from 2003 to 2007. Patients were divided into two groups to compare the treatment response: response group (forced vital capacity (FVC) improves ≥10% after 1 year) and non-response group (FVC <10%). Factors affecting treatment response were evaluated by multivariate logistic regression analysis.RESULTS: A total of 261 patients with iNSIP were enrolled, and 95 patients were followed-up for more than 1 year. Corticosteroid treatment was performed in 86 patients. The treatment group showed a significant improvement in lung function after 1-year: FVC, 10.0%; forced expiratory volume (FEV1), 9.8%; diffusing capacity of the lung for carbon monoxide (DLco), 8.4% (p < 0.001). Sero-negative anti-nuclear antibody (ANA) was significantly related with lung function improvement. Sero-positivity ANA was significantly lower in the response group (p = 0.013), compared to that in the non-response group. A shorter duration of respiratory symptoms at diagnosis was significantly associated with a good response to treatment (p = 0.018).CONCLUSION: Treatment with corticosteroids and/or immunosuppressants improved lung function in iNSIP patients, which was more pronounced in sero-negative ANA and shorter symptom duration patients. These findings suggest that early treatment should be considered in iNSIP patients, even in an early disease stage.

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