The value of biomarkers as predictors of outcome in patients with rheumatoid arthritis-Associated usual interstitial pneumonia

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

Research output: Contribution to journalArticle

4 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)216-223
Number of pages8
JournalSarcoidosis Vasculitis and Diffuse Lung Diseases
Volume33
Issue number3
StatePublished - 2016

Keywords

  • Biomarkers
  • IL-6
  • Interstitial lung disease
  • KL-6
  • Prognosis
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Internal Medicine
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

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    Lee, Y. S., Kim, H. C., Lee, B. Y., Lee, C. K., Kim, M. Y., Jang, S. J., Lee, H. S., Moon, J., Colby, T. V., & Kim, D. S. (2016). The value of biomarkers as predictors of outcome in patients with rheumatoid arthritis-Associated usual interstitial pneumonia. Sarcoidosis Vasculitis and Diffuse Lung Diseases, 33(3), 216-223.