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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 
 Respiratory Research, Vol.18(1) : 204, 2017 
Journal Title
 Respiratory Research 
Issue Date
Adrenal Cortex Hormones/administration & dosage ; Aged ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Idiopathic Interstitial Pneumonias/diagnosis ; Idiopathic Interstitial Pneumonias/drug therapy* ; Idiopathic Interstitial Pneumonias/epidemiology* ; Immunosuppressive Agents/administration & dosage ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Treatment Outcome
Non-specific interstitial pneumonia ; Pulmonary lung function ; Treatment
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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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
김송이(Kim, Song Yee) ORCID logo https://orcid.org/0000-0001-8627-486X
박무석(Park, Moo Suk) ORCID logo https://orcid.org/0000-0003-0820-7615
이상훈(Lee, Sang Hoon) ORCID logo https://orcid.org/0000-0002-7706-5318
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