Efficacy of disease-modifying antirheumatic drugs in primary Sjögren's syndrome-related interstitial lung disease

Objectives

To evaluate the treatment modalities and their effects in primary Sjögren's syndrome (pSS) patients with interstitial lung disease (ILD).

Methods

In this chart review study, patients diagnosed with pSS-related ILD (pSS-ILD) between January 2004 and August 2022 were screened. Glucocorticoid use and administered disease-modifying antirheumatic drugs (DMARDs) were determined. The difference between forced vital capacity (FVC) and diffusion capacity of the lungs for carbon monoxide (DLCO) before and after treatment was evaluated.

Results

ILD was present in 44 of 609 patients (7.2%) diagnosed with pSS. In 27 patients included in the study, steroid usage was 81.5%. There was a statistically insignificant increase in FVC% (from 80.20 ± 22.1 to 81.6 ± 23.0) and a decrease in DLCO% (53.7 ± 15.3–52.2 ± 19.3) with DMARD treatment (p = 0.434 and p = 0.652, respectively). There was no significant difference between the treatment groups (azathioprine [AZA], mycophenolate mofetil [MMF], and rituximab [RTX]) in terms of the change in FVC% and DLCO% compared with baseline levels. The effect of treatment on FVC and DLCO was similar in UIP and NSIP patterns.

Conclusions

AZA, MMF, and RTX have similar effects on pulmonary functions in pSS-ILD and provide disease stabilization.