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Factors affecting treatment outcome in patients with idiopathic nonspecific interstitial pneumonia: a nationwide cohort study
Authors: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
Affiliation:1.Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine,Seoul National University Bundang Hospital,Seongnam-si,Republic of Korea;2.Yonsei University College of Medicine,Seoul,South Korea;3.Department of Internal Medicine, Division of Pulmonology, Severance Hospital, Institute of Chest Diseases,Yonsei University College of Medicine,Seoul,South Korea;4.Division of Pulmonary and Critical Care Medicine,University of Ulsan College of Medicine, Asan Medical Center,Seoul,South Korea;5.Department of Internal Medicine and Lung Institute, Division of Pulmonary and Critical Care Medicine,Seoul National University College of Medicine,Seoul,South Korea;6.Division of Pulmonary and Critical Care Medicine, Samsung Medical Center,Sungkyunkwan University School of Medicine,Seoul,South Korea;7.Department of Internal Medicine, Division of Allergy and Respiratory Medicine,Soonchunhyang University Seoul Hospital,Seoul,South Korea;8.Department of Internal Medicine, Division of Allergy and Respiratory Medicine,Soonchunhyang University Bucheon Hospital,Bucheon,South Korea;9.Department of Internal Medicine, Division of Pulmonology,Gachon University Gil Medical Center,Incheon,South Korea;10.Department of Internal Medicine, Division of Pulmonary, Allergy & Critical Care Medicine, Kangdong Sacred Heart Hospital,Hallym University,Seoul,South Korea;11.Department of Internal Medicine, Pulmonary Division,Inha University Hospital,Incheon,South Korea;12.Department of Internal medicine, Division of Pulmonary Medicine,Chung Ang University College of Medicine,Seoul,South Korea;13.Department of Internal Medicine, Division of Respiratory and Critical Care Medicine, Korea University Anam Hospital,Korea University College of Medicine,Seoul,South Korea;14.Department of Internal Medicine, Ewha Medical Research Institute,Ewha Womans University School of Medicine,Seoul,South Korea;15.Department of Internal Medicine, Division of Pulmonary Medicine, Ulsan University Hospital,University of Ulsan College of Medicine,Ulsan,South Korea;16.Department of Internal Medicine, Division of Critical Care and Pulmonary Medicine,Inje University Busan Paik Hospital,Busan,South Korea;17.Department of Internal Medicine, Division of Allergy and Pulmonology, Bucheon St. Mary’s Hospital,The Catholic University of Korea School of Medicine,Bucheon,South Korea
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?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.
Keywords:
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