Treatment and Systemic Sclerosis Interstitial Lung Disease Outcome: The Overweight Paradox

Nagy, Alexandra and Palmer, Erik and Polivka, Lorinc and Eszes, Noémi and Vincze, Krisztina and Bárczi, Enikő and Bohács, Anikó and Tárnoki, Ádám Domonkos and Tárnoki, Dávid László and Nagy, György and Kiss, Emese and Maurovich-Horvat, Pál and Müller, Veronika (2022) Treatment and Systemic Sclerosis Interstitial Lung Disease Outcome: The Overweight Paradox. BIOMEDICINES, 10 (2). No.-434. ISSN 2227-9059

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Abstract

(1) Background: Systemic sclerosis (SSc) is frequently associated with interstitial lung diseases (ILDs). The progressive form of SSc-ILD often limits patient survival. The aim of our study is to evaluate the clinical characteristics and predictors of lung function changes in SSc-ILD patients treated in a real-world setting. (2) Methods: All SSc-ILD cases previously confirmed by rheumatologists and a multidisciplinary ILD team between January 2017 and June 2019 were included (n = 54). The detailed medical history, clinical parameters and HRCT were analyzed. The longitudinal follow-up for pulmonary symptoms, functional parameters and treatment were performed for at least 2 years in no treatment, immunosuppression and biological treatment subgroups. (3) Results: In SSc-ILD patients (age 58.7 ± 13.3 years, 87.0% women), the main symptoms included dyspnea, cough, crackles and the Raynaud’s phenomenon. The functional decline was most prominent in untreated patients, and a normal body mass index (BMI < 25 kg/m2) was associated with a significant risk of deterioration. The majority of patients improved or were stable during follow-up. The progressive fibrosing-ILD criteria were met by 15 patients, the highest proportion being in the untreated subgroup. (4) Conclusions: SSc-ILD patients who are overweight are at a lower risk of the functional decline and progressive phenotype especially affecting untreated patients. The close monitoring of lung involvement and a regular BMI measurement are advised and early treatment interventions are encouraged.

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