1. Survival in systemic sclerosis associated pulmonary arterial hypertension in the current treatment era-results from a nationwide study.
- Author
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Sarı A, Satış H, Ayan G, Küçükşahin O, Kalyoncu U, Fidancı AA, Ayvalı MO, Ata N, Ülgü MM, Birinci Ş, and Akdoğan A
- Subjects
- Humans, Female, Male, Middle Aged, Retrospective Studies, Aged, Turkey epidemiology, Survival Rate, Kaplan-Meier Estimate, Antihypertensive Agents therapeutic use, Hypertension, Pulmonary mortality, Hypertension, Pulmonary drug therapy, Hypertension, Pulmonary etiology, Scleroderma, Systemic complications, Scleroderma, Systemic mortality, Pulmonary Arterial Hypertension drug therapy, Pulmonary Arterial Hypertension mortality, Immunosuppressive Agents therapeutic use
- Abstract
Introduction: Pulmonary arterial hypertension (PAH) is a leading cause of mortality in systemic sclerosis (SSc). This nationwide study aims to describe real world treatment characteristics and assess survival rates of patients with SSc-PAH., Methods: In this retrospective cohort study, patients with SSc-PAH were identified from Turkish Ministry of Health National Electronic Database (from January 2016 to September 2022), using ICD-10 codes. Data on demographics, treatment characteristics, and death was collected. Kaplan-Meier curves were used to calculate cumulative probabilities of survival at 1, 3, and 5 years., Results: Five hundred forty-seven patients (90.7% female) with SSc-PAH were identified. Median age at PAH diagnosis was 59.9 (50.0-67.4) years. During a median follow-up duration of 3.2 (1.5-4.8) years, 199 (36.4%) deaths occurred. Estimated survival rates at 1, 3, and 5 years were 90.2%, 73.2%, and 56.6%, respectively. Survival was similar among patients with and without interstitial lung disease (p = 0.20). Patients who used immunosuppressives had better survival than those who did not (p < 0.001). No difference was observed in survival rates according to initial PAH-specific treatment regimen (monotherapy or combination) (p = 0.49)., Conclusion: Compared to most of historical cohorts, higher survival rates for SSc-PAH were observed in this study. Early diagnosis of PAH may have contributed to these findings. The impact of immunosuppressive therapy on prognosis of SSc-PAH needs to be further investigated in prospective studies. Key Points • Early diagnosis is pivotal for better outcomes in SSc-PAH. • Implementation of PAH treatment guidelines in routine clinical practice is still poor and should be improved. • Effect of immunosuppressive therapies on disease course has to be defined in SSc-PAH., (© 2024. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)
- Published
- 2024
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