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Ann Rheum Dis. 2016 Jul;75(7):1367-71. doi: 10.1136/annrheumdis-2015-208929. Epub 2016 Jan 12.

Transitions to different patterns of interstitial lung disease in scleroderma with and without treatment.

Author information

1
Department of Radiological Science, Center for Computer Vision Imaging Biomarker, David Geffen School of Medicine at UCLA, Los Angeles, California, USA Department of Biostatistics, Fielding School of Public Health at UCLA, Los Angeles, California, USA.
2
Division of Pulmonary and Critical Care Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
3
Department of Radiological Science, Center for Computer Vision Imaging Biomarker, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
4
Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
5
Department of Biostatistics, Fielding School of Public Health at UCLA, Los Angeles, California, USA Department of Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
6
Department of Biomathematics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
7
Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Abstract

OBJECTIVES:

The aim is to investigate whether the 12-month quantitative changes in high-resolution CT (HRCT) measures of interstitial lung disease (ILD) are different, and to understand how they change, in patients with scleroderma-related ILD who receive drug therapy versus placebo.

METHODS:

HRCT images were acquired at baseline and at 12 months in 83 participants in Scleroderma Lung Study I, a clinical trial comparing treatment with oral cyclophosphamide versus placebo. A computer-aided model was used to quantify the extent of fibrotic reticulation, ground glass and honeycomb patterns and quantitative ILD (QILD: sum of these patterns) in the whole lung and the lung zone (upper, middle or lower) of maximal disease involvement.

RESULTS:

Mean QILD score decreased by 3.9% in the cyclophosphamide group while increasing by 4.2% in the placebo group in the most severe zone (p=0.01) and decreased by 3.2% in the cyclophosphamide group while increasing by 2.2% in the placebo group in the whole lung (p=0.03). Transitional probabilities demonstrated greater changes from a fibrotic to either a ground glass or normal pattern in the cyclophosphamide group and the reverse in the placebo group.

CONCLUSIONS:

Changes in quantitative HRCT measures of ILD provide a sensitive indication of disease progression and response to treatment.

TRIAL REGISTRATION NUMBER:

NCT00004563; Post-results.

KEYWORDS:

Outcomes research; Pulmonary Fibrosis; Systemic Sclerosis; Treatment

PMID:
26757749
DOI:
10.1136/annrheumdis-2015-208929
[Indexed for MEDLINE]

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