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Abstract：
BACKGROUND: Acute exacerbation of idiopathic interstitial pneumonias (AE-IIPs) has a high mortality. However, there is no established treatment for AE-IIPs. Therefore, we aimed to compare the efficacy of high- and low-dose corticosteroid therapies in AE-IIPs patients.
METHODS: Data were retrospectively collected from the Japanese Diagnosis Procedure Combination database from July 2010 to March 2018. Adult patients with AE-IIPs who received high-dose (methylprednisolone at a dose of 500-1000 mg/day for 3 days starting within 4 days after admission) or low-dose (methylprednisolone at a dose of 100-200 mg/day for at least 5 days starting within 4 days after admission) corticosteroid therapy were identified. Eligible patients (n = 17,317) were divided into the high-dose (n = 16,998) and low-dose (n = 319) groups. A stabilized inverse probability of treatment weighting using propensity scores was performed to compare outcomes between the groups.
RESULTS: The primary outcome was in-hospital mortality, and the secondary outcomes were 28-day mortality, infections during hospitalization, length of hospitalization, duration of steroid use, and discharge to home. The in-hospital mortality rates of the high- and low-dose corticosteroid groups were 50.6% and 47.0%, respectively. In-hospital mortality did not significantly differ between the two groups after stabilized inverse probability of treatment weighting, and the odds ratio in the low-dose corticosteroid group was 0.86 (95% confidence interval: 0.64-1.16; p = 0.33). The secondary outcomes also did not significantly differ between the groups.
CONCLUSIONS: There was no significant difference in outcomes between patients with AE-IIPs who received high- and low-dose corticosteroid therapies.
METHODS: Data were retrospectively collected from the Japanese Diagnosis Procedure Combination database from July 2010 to March 2018. Adult patients with AE-IIPs who received high-dose (methylprednisolone at a dose of 500-1000 mg/day for 3 days starting within 4 days after admission) or low-dose (methylprednisolone at a dose of 100-200 mg/day for at least 5 days starting within 4 days after admission) corticosteroid therapy were identified. Eligible patients (n = 17,317) were divided into the high-dose (n = 16,998) and low-dose (n = 319) groups. A stabilized inverse probability of treatment weighting using propensity scores was performed to compare outcomes between the groups.
RESULTS: The primary outcome was in-hospital mortality, and the secondary outcomes were 28-day mortality, infections during hospitalization, length of hospitalization, duration of steroid use, and discharge to home. The in-hospital mortality rates of the high- and low-dose corticosteroid groups were 50.6% and 47.0%, respectively. In-hospital mortality did not significantly differ between the two groups after stabilized inverse probability of treatment weighting, and the odds ratio in the low-dose corticosteroid group was 0.86 (95% confidence interval: 0.64-1.16; p = 0.33). The secondary outcomes also did not significantly differ between the groups.
CONCLUSIONS: There was no significant difference in outcomes between patients with AE-IIPs who received high- and low-dose corticosteroid therapies.
摘要：
背景：特发性间质性肺炎（AE-IIPs）急性加重具有高死亡率。然而,没有确定的AE-IIP治疗方法。因此,我们旨在比较AE-IIPs患者高剂量和低剂量皮质类固醇治疗的疗效.
方法：数据回顾性收集自2010年7月至2018年3月的日本诊断程序组合数据库。确定了接受高剂量（甲基强的松龙500-1000mg/天，从入院后4天内开始3天）或低剂量（甲基强的松龙100-200mg/天，从入院后4天内开始至少5天）皮质类固醇治疗的AE-IIP成年患者。符合条件的患者（n=17,317）被分为高剂量组（n=16,998）和低剂量组（n=319）。使用倾向评分进行稳定的治疗加权逆概率以比较组间的结果。
结果：主要结局是住院死亡率，次要结局是28天死亡率，住院期间感染，住院时间,类固醇使用的持续时间，出院回家。高、低剂量糖皮质激素组的住院死亡率分别为50.6%和47.0%,分别。在稳定的治疗权重逆概率后，两组的住院死亡率没有显着差异。低剂量皮质类固醇组的比值比为0.86（95％置信区间：0.64-1.16；p=0.33）。两组之间的次要结果也没有显着差异。
结论：接受高剂量和低剂量皮质类固醇治疗的AE-IIP患者的预后没有显著差异。
方法：数据回顾性收集自2010年7月至2018年3月的日本诊断程序组合数据库。确定了接受高剂量（甲基强的松龙500-1000mg/天，从入院后4天内开始3天）或低剂量（甲基强的松龙100-200mg/天，从入院后4天内开始至少5天）皮质类固醇治疗的AE-IIP成年患者。符合条件的患者（n=17,317）被分为高剂量组（n=16,998）和低剂量组（n=319）。使用倾向评分进行稳定的治疗加权逆概率以比较组间的结果。
结果：主要结局是住院死亡率，次要结局是28天死亡率，住院期间感染，住院时间,类固醇使用的持续时间，出院回家。高、低剂量糖皮质激素组的住院死亡率分别为50.6%和47.0%,分别。在稳定的治疗权重逆概率后，两组的住院死亡率没有显着差异。低剂量皮质类固醇组的比值比为0.86（95％置信区间：0.64-1.16；p=0.33）。两组之间的次要结果也没有显着差异。
结论：接受高剂量和低剂量皮质类固醇治疗的AE-IIP患者的预后没有显著差异。
