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Clinical Trial
. 2023 May 2;62(5):1870-1876.
doi: 10.1093/rheumatology/keac535.

Extent of fibrosis and lung function decline in patients with systemic sclerosis and interstitial lung disease: data from the SENSCIS trial

Christopher P Denton  1 , Nicole S Goh  2 , Stephen M Humphries  3 , Toby M Maher  4   5 , Robert Spiera  6 , Anand Devaraj  7 , Lawrence Ho  8 , Christian Stock  9 , Elvira Erhardt  10 , Margarida Alves  11 , Athol U Wells  12
Affiliations
Clinical Trial

Extent of fibrosis and lung function decline in patients with systemic sclerosis and interstitial lung disease: data from the SENSCIS trial

Christopher P Denton et al. Rheumatology (Oxford). .

Abstract

Objective: To assess associations between the extent of fibrotic interstitial lung disease (ILD) and forced vital capacity (FVC) at baseline and change in FVC over 52 weeks in patients with systemic sclerosis-associated ILD (SSc-ILD) in the SENSCIS trial.

Material and methods: We used generalized additive models, which involve few assumptions and allow for interaction between non-linear effects, to assess associations between the extent of fibrotic ILD on high-resolution computed tomography (HRCT), and the interplay of extent of fibrotic ILD on HRCT and FVC % predicted, at baseline and FVC decline over 52 weeks.

Results: In the placebo group (n = 288), there was weak evidence of a modest association between a greater extent of fibrotic ILD at baseline and a greater decline in FVC % predicted at week 52 [r: -0.09 (95% CI -0.2, 0.03)]. Higher values of both the extent of fibrotic ILD and FVC % predicted at baseline tended to be associated with greater decline in FVC % predicted at week 52. In the nintedanib group (n = 288), there was no evidence of an association between the extent of fibrotic ILD at baseline and decline in FVC % predicted at week 52 [r: 0.01 (95% CI: -0.11, 0.12)] or between the interplay of extent of fibrotic ILD and FVC % predicted at baseline and decline in FVC % predicted at week 52.

Conclusions: Data from the SENSCIS trial suggest that patients with SSc-ILD are at risk of ILD progression and benefit from nintedanib largely irrespective of their extent of fibrotic ILD at baseline.

Study registration: ClinicalTrials.gov, https://clinicaltrials.gov, NCT02597933.

Keywords: autoimmune diseases; pulmonary fibrosis; vital capacity.

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Figures

Figure 1.
Figure 1.
Associations between extent of fibrotic ILD at baseline and change in FVC. Associations between extent of fibrotic ILD on HRCT at baseline and change in FVC % predicted at week 52. Dashed lines indicate 95% confidence intervals. FVC: forced vital capacity; HRCT: high-resolution CT; ILD: interstitial lung disease
Figure 2.
Figure 2.
Associations between extent of fibrotic ILD at baseline and change in FVC in mycophenolate subgroups. Associations between extent of fibrotic ILD on HRCT at baseline and change in FVC % predicted at week 52 in subgroups by mycophenolate use at baseline. Dashed lines indicate 95% CIs. FVC: forced vital capacity; HRCT: high-resolution CT; ILD: interstitial lung disease
Figure 3.
Figure 3.
Change in FVC by extent of fibrotic ILD and FVC at baseline. Contour plots of change in FVC % predicted at week 52 by extent of fibrotic ILD on HRCT and FVC % predicted at baseline. Darker shading indicates greater decline in FVC % predicted at week 52. FVC: forced vital capacity; HRCT: high-resolution CT; ILD: interstitial lung disease
Figure 4.
Figure 4.
Change in FVC by extent of fibrotic ILD and FVC at baseline in mycophenolate subgroups. Contour plots of change in FVC % predicted at week 52 by extent of fibrotic ILD on HRCT and FVC % predicted at baseline in subgroups by mycophenolate use at baseline. Darker shading indicates greater decline in FVC % predicted at week 52. FVC: forced vital capacity; HRCT: high-resolution CT; ILD: interstitial lung disease
Figure 5.
Figure 5.
Associations between extent of fibrotic ILD on HRCT and FVC % predicted at baseline. FVC: forced vital capacity; HRCT: high-resolution CT; ILD: interstitial lung disease
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References

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