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. 2024 Jun 25;26(1):124.
doi: 10.1186/s13075-024-03355-0.

The impact of gastroesophageal reflux disease and its treatment on interstitial lung disease outcomes

A Quinlivan  1   2 , D Neuen  3 , D Hansen  1 , W Stevens  1 , L Ross  1   2 , N Ferdowsi  1   2 , S M Proudman  4   5 , J G Walker  4   6   7 , J Sahhar  8   9 , G-S Ngian  8   9 , D Apostolopoulos  8   10 , L V Host  11 , G Major  12   13 , C Basnayake  2   14 , K Morrisroe #  1   2 , M Nikpour #  15   16   17   18
Affiliations

The impact of gastroesophageal reflux disease and its treatment on interstitial lung disease outcomes

A Quinlivan et al. Arthritis Res Ther. .

Abstract

Background: To determine the relationship between gastroesophageal reflux disease (GORD) and its treatment and interstitial lung disease in patients with systemic sclerosis (SSc).

Methods: SSc patients from the Australian Scleroderma Cohort Study (ASCS) were included. GORD was defined as self-reported GORD symptoms, therapy with a proton pump inhibitor (PPI) or histamine 2 receptor antagonist (H2RA) and/or the presence of reflux oesophagitis diagnosed endoscopically. The impact of GORD and its treatment on ILD features (including severity and time to ILD development) and survival was evaluated.

Results: GORD was a common manifestation affecting 1539/1632 (94%) of SSc patients. GORD affected 450/469 (96%) of those with SSc-ILD cohort. In SSc-ILD, there was no relationship between the presence of GORD or its treatment and time to ILD development or ILD severity. However, GORD treatment was associated with improved survival in those with ILD (p = 0.002). Combination therapy with both a PPI and a H2RA was associated with a greater survival benefit than single agent therapy with PPI alone (HR 0.3 vs 0.5 p < 0.050 respectively).

Conclusion: GORD is a common SSc disease manifestation. While the presence or treatment of GORD does not influence the development or severity of ILD, aggressive GORD treatment, in particular with a combination of PPI and H2RA, is associated with improved survival in those with SSc-ILD.

Keywords: Gastro-oesophageal reflux disease; Interstitial lung disease; Systemic sclerosis.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Shows the Kaplan-Meier survival curve from date of ILD onset to all-cause mortality by GORD treatment agent for patients with GORD
See this image and copyright information in PMC

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