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Clinical Rheumatology

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30-01-2024 | Glucocorticoid | Original Article

Effect of high-dose intravenous methylprednisolone pulse (IVMP) therapy in the survival of patients with anti-melanoma differentiation-associated gene 5-related rapidly progressive interstitial lung disease: a retrospective analysis

Authors: Li Fan, Yan Li, Wenting Lyu, Qingqing Xu, Yujuan Gao, Xiaohua Qiu, Hourong Cai, Jinghong Dai

Published in: Clinical Rheumatology | Issue 3/2024

Abstract

Objectives

To assess the impacts of high-dose intravenous methylprednisolone pulse (IVMP) therapy in survival and the occurrences of treatment-related infection of patients with anti-melanoma differentiation-associated gene 5 antibody-related rapidly progressive interstitial lung disease (MDA5-RPILD).

Methods

Patients with MDA5-RPILD from June 2017 to August 2022 in our hospital were retrospectively reviewed. IVMP therapy was defined as intravenous methylprednisolone (mPSL) 0.5g/day for 3 consecutive days during hospitalization or 7 days prior to admission and patients were divided into IVMP group and non-IVMP group based on who had ever received IVMP therapy. All-cause mortality and the incidence of adverse events during treatment were compared between the two groups.

Results

Sixty-four patients with MDA5-RPILD were enrolled. Among them, twenty-three (35.9%) patients had ever received IVMP therapy. The overall mortality was comparable between IVMP and non-IVMP group (IVMP group: 22/23, 95.7% vs. non-IVMP group: 38/41, 92.7%, p=0.11). And the incidence of treatment-related infections was also close (IVMP group: 21/23, 91.3% vs. non-IVMP group: 32/41, 78.0%, p=0.30). After adjustment for gender, age, smoking history, duration from symptom onset to diagnosis, and combination with steroid-sparing agent treatment, the Cox proportional hazards model showed that IVMP therapy was not associated with an improved survival (adjusted HR 1.10; 95% CI 0.57–2.13; p=0.77).

Conclusion

Our study showed that the survival benefits and adverse events were comparable between IVMP-treated and untreated MDA5-RPILD patients. Future prospective trials are needed to investigate the optimal treatment regimen in MDA5-RPILD.

Key Points

• This observational study found that IVMP therapy may be not associated with an improved outcome in patients with MDA5-RPILD.

• Treatment-related infections are common; however, the incidence of treatment-related infections had no difference between IVMP and non-IVMP group.

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Title: Effect of high-dose intravenous methylprednisolone pulse (IVMP) therapy in the survival of patients with anti-melanoma differentiation-associated gene 5-related rapidly progressive interstitial lung disease: a retrospective analysis
Authors: Li Fan
Yan Li
Wenting Lyu
Qingqing Xu
Yujuan Gao
Xiaohua Qiu
Hourong Cai
Jinghong Dai
Publication date: 30-01-2024
Publisher: Springer International Publishing
Keywords: Glucocorticoid
Melanoma
Melanoma
Published in: Clinical Rheumatology / Issue 3/2024
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-024-06872-0

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