Systematic review and meta-analysis of prognostic factors for idiopathic inflammatory myopathy-associated interstitial lung disease

Hiroyuki Kamiya, Ogee Mer Panlaqui, Shinyu Izumi, Takashi Sozu

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Objective: To clarify prognostic factors for idiopathic inflammatory myopathy (IIM)-associated interstitial lung disease (ILD). Design: Systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation system. Data sources: Medline, EMBASE and Science Citation Index Expanded were searched through 9 August 2018. Eligibility criteria for selecting studies: The review includes primary studies addressing all-cause mortality of IIM-associated ILD. Potential prognostic factors were any clinical information related to the outcome. Data extraction and synthesis: Two reviewers extracted relevant data independently and assessed risk of bias using the Quality in Prognostic Studies tool. Meta-analysis was conducted using a random effects model and if inappropriate the results were reported qualitatively. Prognostic factors were determined based on statistically significant results derived from multivariate analysis. Results: Of a total of 5892 articles returned, 32 were deemed eligible for analysis and cumulatively, these studies reported 28 potential prognostic factors for all-cause mortality. Each study was subject to certain methodological constraints. The four prognostic factors, which demonstrated statistically significant results on both univariate and multivariate analyses, were as follows: age (MD 5.90, 3.17-8.63/HR 1.06, 1.02-1.10 and 2.31, 1.06-5.06), acute/subacute interstitial pneumonia (A/SIP) (OR 4.85, 2.81-8.37/HR 4.23, 1.69-12.09 and 5.17, 1.94-13.49), percentage of predicted forced vital capacity (%FVC) (OR 0.96, 0.95-0.98/HR 0.96, 0.93-0.99) and anti-Jo-1 antibody (OR 0.35, 0.18-0.71/HR 0.004, 0.00003-0.54) (univariate/multivariate, 95% CI). Other prognostic factors included ground glass opacity/attenuation (GGO/GGA) and extent of radiological abnormality. The quality of the presented evidence was rated as either low or very low. Conclusions: Older age, A/SIP, lower value of %FVC, GGO/GGA and extent of radiological abnormality were demonstrated to predict poor prognosis for IIM-associated ILD while a positive test for anti-Jo-1 antibody indicated better prognosis. However, given the weak evidence they should be interpreted with caution.

Original languageEnglish
Article numbere023998
JournalBMJ Open
Volume8
Issue number12
DOIs
Publication statusPublished - 1 Dec 2018

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Myositis
Interstitial Lung Diseases
Meta-Analysis
Multivariate Analysis
Mortality
Information Storage and Retrieval
Vital Capacity
Glass

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@article{53da9cd243444e07a765c42b887923b8,
title = "Systematic review and meta-analysis of prognostic factors for idiopathic inflammatory myopathy-associated interstitial lung disease",
abstract = "Objective: To clarify prognostic factors for idiopathic inflammatory myopathy (IIM)-associated interstitial lung disease (ILD). Design: Systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation system. Data sources: Medline, EMBASE and Science Citation Index Expanded were searched through 9 August 2018. Eligibility criteria for selecting studies: The review includes primary studies addressing all-cause mortality of IIM-associated ILD. Potential prognostic factors were any clinical information related to the outcome. Data extraction and synthesis: Two reviewers extracted relevant data independently and assessed risk of bias using the Quality in Prognostic Studies tool. Meta-analysis was conducted using a random effects model and if inappropriate the results were reported qualitatively. Prognostic factors were determined based on statistically significant results derived from multivariate analysis. Results: Of a total of 5892 articles returned, 32 were deemed eligible for analysis and cumulatively, these studies reported 28 potential prognostic factors for all-cause mortality. Each study was subject to certain methodological constraints. The four prognostic factors, which demonstrated statistically significant results on both univariate and multivariate analyses, were as follows: age (MD 5.90, 3.17-8.63/HR 1.06, 1.02-1.10 and 2.31, 1.06-5.06), acute/subacute interstitial pneumonia (A/SIP) (OR 4.85, 2.81-8.37/HR 4.23, 1.69-12.09 and 5.17, 1.94-13.49), percentage of predicted forced vital capacity ({\%}FVC) (OR 0.96, 0.95-0.98/HR 0.96, 0.93-0.99) and anti-Jo-1 antibody (OR 0.35, 0.18-0.71/HR 0.004, 0.00003-0.54) (univariate/multivariate, 95{\%} CI). Other prognostic factors included ground glass opacity/attenuation (GGO/GGA) and extent of radiological abnormality. The quality of the presented evidence was rated as either low or very low. Conclusions: Older age, A/SIP, lower value of {\%}FVC, GGO/GGA and extent of radiological abnormality were demonstrated to predict poor prognosis for IIM-associated ILD while a positive test for anti-Jo-1 antibody indicated better prognosis. However, given the weak evidence they should be interpreted with caution.",
keywords = "idiopathic inflammatory myopathy, interstitial lung disease, meta-analysis, prognosis, systematic review",
author = "Hiroyuki Kamiya and Panlaqui, {Ogee Mer} and Shinyu Izumi and Takashi Sozu",
year = "2018",
month = "12",
day = "1",
doi = "10.1136/bmjopen-2018-023998",
language = "English",
volume = "8",
journal = "BMJ (Open)",
issn = "2044-6055",
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}

Systematic review and meta-analysis of prognostic factors for idiopathic inflammatory myopathy-associated interstitial lung disease. / Kamiya, Hiroyuki; Panlaqui, Ogee Mer; Izumi, Shinyu; Sozu, Takashi.

In: BMJ Open, Vol. 8, No. 12, e023998, 01.12.2018.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Systematic review and meta-analysis of prognostic factors for idiopathic inflammatory myopathy-associated interstitial lung disease

AU - Kamiya, Hiroyuki

AU - Panlaqui, Ogee Mer

AU - Izumi, Shinyu

AU - Sozu, Takashi

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Objective: To clarify prognostic factors for idiopathic inflammatory myopathy (IIM)-associated interstitial lung disease (ILD). Design: Systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation system. Data sources: Medline, EMBASE and Science Citation Index Expanded were searched through 9 August 2018. Eligibility criteria for selecting studies: The review includes primary studies addressing all-cause mortality of IIM-associated ILD. Potential prognostic factors were any clinical information related to the outcome. Data extraction and synthesis: Two reviewers extracted relevant data independently and assessed risk of bias using the Quality in Prognostic Studies tool. Meta-analysis was conducted using a random effects model and if inappropriate the results were reported qualitatively. Prognostic factors were determined based on statistically significant results derived from multivariate analysis. Results: Of a total of 5892 articles returned, 32 were deemed eligible for analysis and cumulatively, these studies reported 28 potential prognostic factors for all-cause mortality. Each study was subject to certain methodological constraints. The four prognostic factors, which demonstrated statistically significant results on both univariate and multivariate analyses, were as follows: age (MD 5.90, 3.17-8.63/HR 1.06, 1.02-1.10 and 2.31, 1.06-5.06), acute/subacute interstitial pneumonia (A/SIP) (OR 4.85, 2.81-8.37/HR 4.23, 1.69-12.09 and 5.17, 1.94-13.49), percentage of predicted forced vital capacity (%FVC) (OR 0.96, 0.95-0.98/HR 0.96, 0.93-0.99) and anti-Jo-1 antibody (OR 0.35, 0.18-0.71/HR 0.004, 0.00003-0.54) (univariate/multivariate, 95% CI). Other prognostic factors included ground glass opacity/attenuation (GGO/GGA) and extent of radiological abnormality. The quality of the presented evidence was rated as either low or very low. Conclusions: Older age, A/SIP, lower value of %FVC, GGO/GGA and extent of radiological abnormality were demonstrated to predict poor prognosis for IIM-associated ILD while a positive test for anti-Jo-1 antibody indicated better prognosis. However, given the weak evidence they should be interpreted with caution.

AB - Objective: To clarify prognostic factors for idiopathic inflammatory myopathy (IIM)-associated interstitial lung disease (ILD). Design: Systematic review and meta-analysis using the Grades of Recommendation, Assessment, Development and Evaluation system. Data sources: Medline, EMBASE and Science Citation Index Expanded were searched through 9 August 2018. Eligibility criteria for selecting studies: The review includes primary studies addressing all-cause mortality of IIM-associated ILD. Potential prognostic factors were any clinical information related to the outcome. Data extraction and synthesis: Two reviewers extracted relevant data independently and assessed risk of bias using the Quality in Prognostic Studies tool. Meta-analysis was conducted using a random effects model and if inappropriate the results were reported qualitatively. Prognostic factors were determined based on statistically significant results derived from multivariate analysis. Results: Of a total of 5892 articles returned, 32 were deemed eligible for analysis and cumulatively, these studies reported 28 potential prognostic factors for all-cause mortality. Each study was subject to certain methodological constraints. The four prognostic factors, which demonstrated statistically significant results on both univariate and multivariate analyses, were as follows: age (MD 5.90, 3.17-8.63/HR 1.06, 1.02-1.10 and 2.31, 1.06-5.06), acute/subacute interstitial pneumonia (A/SIP) (OR 4.85, 2.81-8.37/HR 4.23, 1.69-12.09 and 5.17, 1.94-13.49), percentage of predicted forced vital capacity (%FVC) (OR 0.96, 0.95-0.98/HR 0.96, 0.93-0.99) and anti-Jo-1 antibody (OR 0.35, 0.18-0.71/HR 0.004, 0.00003-0.54) (univariate/multivariate, 95% CI). Other prognostic factors included ground glass opacity/attenuation (GGO/GGA) and extent of radiological abnormality. The quality of the presented evidence was rated as either low or very low. Conclusions: Older age, A/SIP, lower value of %FVC, GGO/GGA and extent of radiological abnormality were demonstrated to predict poor prognosis for IIM-associated ILD while a positive test for anti-Jo-1 antibody indicated better prognosis. However, given the weak evidence they should be interpreted with caution.

KW - idiopathic inflammatory myopathy

KW - interstitial lung disease

KW - meta-analysis

KW - prognosis

KW - systematic review

UR - http://www.scopus.com/inward/record.url?scp=85058735493&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2018-023998

DO - 10.1136/bmjopen-2018-023998

M3 - Review article

VL - 8

JO - BMJ (Open)

JF - BMJ (Open)

SN - 2044-6055

IS - 12

M1 - e023998

ER -