Serum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysis
Abstract Background The role of chronic inflammation in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease (non-IPF f-ILD) remains unclear, with varied responses to anti-inflammatory or immunosuppressive therapy. A reliable predictor for guiding treatment response may enhance clini...
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BMC
2025-05-01
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| Series: | BMC Pulmonary Medicine |
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| Online Access: | https://doi.org/10.1186/s12890-025-03703-z |
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| author | Yanisa Kluanwan Teng Moua |
| author_facet | Yanisa Kluanwan Teng Moua |
| author_sort | Yanisa Kluanwan |
| collection | DOAJ |
| description | Abstract Background The role of chronic inflammation in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease (non-IPF f-ILD) remains unclear, with varied responses to anti-inflammatory or immunosuppressive therapy. A reliable predictor for guiding treatment response may enhance clinical decision-making and minimize adverse treatment effects. We hypothesized that elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) may be associated with improved treatment response. Methods Our retrospective cohort study compared treatment response to anti-inflammatory therapy in patients with non-IPF f-ILD stratified by baseline CRP and ESR levels. Treatment response was defined as: (1) relative increase in percent predicted forced vital capacity (FVC%) ≥ 5% in 6 months or ≥ 10% in 12 months; or (2) no change or any increase in FVC% if FVC% decline was noted prior to treatment. Logistic regression was used to delineate outcome predictors with FVC% change over time assessed with linear mixed effects models. Results Of 832 non-IPF f-ILD patients screened, 167 received anti-inflammatory therapy and baseline inflammatory marker testing stratified into high vs. low-to-normal groups (104 vs. 63, respectively). Median age was 64 years, and 57% were diagnosed with a systemic autoimmune rheumatic disease (SARD). Treatment response was greater in those with elevated inflammatory markers (56% vs. 35%; OR 2.45 [1.243–4.828] P = 0.010) even after adjustment for a priori covariables. SARD diagnosis was associated with treatment response (OR 2.90 [1.45–5.81] P = 0.003), independent of inflammatory marker level. A positive FVC% slope was observed in treated patients with initially elevated inflammatory markers (P = 0.003). Conclusion Patients with non-IPF f-ILD and elevated inflammatory markers appear to be more responsive to anti-inflammatory therapy with slower FVC decline over time. These findings suggest baseline serum ESR and CRP may be feasible and reliable predictors of treatment response in certain subgroups. |
| format | Article |
| id | doaj-art-e86c377f754c474ea36a96288878d408 |
| institution | Kabale University |
| issn | 1471-2466 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj-art-e86c377f754c474ea36a96288878d4082025-08-20T03:53:08ZengBMCBMC Pulmonary Medicine1471-24662025-05-0125111210.1186/s12890-025-03703-zSerum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysisYanisa Kluanwan0Teng Moua1Division of Pulmonary and Critical Care Medicine, Central Chest Institute of ThailandDivision of Pulmonary and Critical Care Medicine, Mayo ClinicAbstract Background The role of chronic inflammation in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease (non-IPF f-ILD) remains unclear, with varied responses to anti-inflammatory or immunosuppressive therapy. A reliable predictor for guiding treatment response may enhance clinical decision-making and minimize adverse treatment effects. We hypothesized that elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) may be associated with improved treatment response. Methods Our retrospective cohort study compared treatment response to anti-inflammatory therapy in patients with non-IPF f-ILD stratified by baseline CRP and ESR levels. Treatment response was defined as: (1) relative increase in percent predicted forced vital capacity (FVC%) ≥ 5% in 6 months or ≥ 10% in 12 months; or (2) no change or any increase in FVC% if FVC% decline was noted prior to treatment. Logistic regression was used to delineate outcome predictors with FVC% change over time assessed with linear mixed effects models. Results Of 832 non-IPF f-ILD patients screened, 167 received anti-inflammatory therapy and baseline inflammatory marker testing stratified into high vs. low-to-normal groups (104 vs. 63, respectively). Median age was 64 years, and 57% were diagnosed with a systemic autoimmune rheumatic disease (SARD). Treatment response was greater in those with elevated inflammatory markers (56% vs. 35%; OR 2.45 [1.243–4.828] P = 0.010) even after adjustment for a priori covariables. SARD diagnosis was associated with treatment response (OR 2.90 [1.45–5.81] P = 0.003), independent of inflammatory marker level. A positive FVC% slope was observed in treated patients with initially elevated inflammatory markers (P = 0.003). Conclusion Patients with non-IPF f-ILD and elevated inflammatory markers appear to be more responsive to anti-inflammatory therapy with slower FVC decline over time. These findings suggest baseline serum ESR and CRP may be feasible and reliable predictors of treatment response in certain subgroups.https://doi.org/10.1186/s12890-025-03703-zInterstitial lung diseaseLung fibrosisAnti-inflammatory treatmentImmunosuppression |
| spellingShingle | Yanisa Kluanwan Teng Moua Serum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysis BMC Pulmonary Medicine Interstitial lung disease Lung fibrosis Anti-inflammatory treatment Immunosuppression |
| title | Serum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysis |
| title_full | Serum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysis |
| title_fullStr | Serum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysis |
| title_full_unstemmed | Serum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysis |
| title_short | Serum inflammatory markers as predictors of therapeutic response in non-idiopathic pulmonary fibrosis fibrotic interstitial lung disease: a retrospective cohort analysis |
| title_sort | serum inflammatory markers as predictors of therapeutic response in non idiopathic pulmonary fibrosis fibrotic interstitial lung disease a retrospective cohort analysis |
| topic | Interstitial lung disease Lung fibrosis Anti-inflammatory treatment Immunosuppression |
| url | https://doi.org/10.1186/s12890-025-03703-z |
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