A Retrospective Analysis of Outcome in Melanoma Differentiation–Associated Gene 5–Related Interstitial Lung Disease Treated with Tofacitinib or Tacrolimus

作者：Fan Li, Wenting Lyu, Huarui Liu, Hanyi Jiang, Lulu Chen, Yin Liu, Yi Zhuang, Mei Huang, Min Cao, Hourong Cai, Yonglong Xiao, Jinghong Dai · 发表于：The Journal of Rheumatology · 年份：2022 · DOI：10.3899/jrheum.220367 · 被引用次数：43 · 研究领域：Melanoma and MAPK Pathways、Inflammatory Myopathies and Dermatomyositis、Psoriasis: Treatment and Pathogenesis

Objective The efficacy of tofacitinib (TOF) in the early diagnosis of melanoma differentiation–associated gene 5 (MDA5)–related interstitial lung disease (ILD) has been described. However, whether TOF exposure is associated with a reduced 1-year mortality rate remains undetermined. Methods Patients diagnosed with MDA5-ILD receiving TOF or tacrolimus (TAC) treatment were included. A Cox proportional hazards model, which was adjusted for age, sex, smoking history, anti-MDA5 antibody titers, and concurrent use of other steroid-sparing agents, was performed to compare all-cause mortality and to investigate the risk factors predicting 1-year mortality rates in the 2 treatment groups. Results During the study period, 26 patients were treated with TOF and 35 were treated with TAC. The 6-month (38.5% vs 62.9%; P = 0.03) and 1-year (44.0% vs 65.7%; P = 0.03) mortality rates in the TOF group were significantly lower than those in the TAC group. There were 13 patients diagnosed with rapidly progressive ILD (RP-ILD) in the TOF group and 22 in the TAC group. The majority of deaths occurred in patients with RP-ILD. The 6-month (76.9% vs 95.5%; P = 0.02) and 1-year (84.6% vs 100.0%; P = 0.02) mortality rates of patients with RP-ILD in the TOF group were also lower than those in the TAC group, respectively. The adjusted model showed that TOF exposure was associated with a lower risk for 1-year mortality (hazard ratio 0.44, 95% CI 0.20-0.96; P = 0.04). However, the incidence of adverse events...