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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).
CONCLUSIONS: 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.
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).
CONCLUSIONS: 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.
摘要：
背景：确定胃食管反流病（GORD）及其治疗与系统性硬化症（SSc）患者间质性肺病之间的关系。
方法：纳入来自澳大利亚硬皮病队列研究（ASCS）的SSc患者。GORD被定义为自我报告的GORD症状，使用质子泵抑制剂（PPI）或组胺2受体拮抗剂（H2RA）治疗和/或内镜诊断的反流性食管炎。评估了GORD及其治疗对ILD特征（包括严重程度和ILD发展时间）和生存率的影响。
结果：GORD是影响1539/1632（94％）SSc患者的常见表现。GORD影响了450/469（96％）的SSc-ILD队列。在SSc-ILD中,GORD的存在或其治疗与ILD发展时间或ILD严重程度之间没有关系.然而,GORD治疗与ILD患者生存率改善相关(p=0.002)。PPI和H2RA联合治疗比单独使用PPI的单药治疗具有更大的生存益处（HR分别为0.3vs0.5p<0.050）。
结论：GORD是一种常见的SSc疾病表现。虽然GORD的存在或治疗不会影响ILD的发展或严重程度，积极的GORD治疗，特别是PPI和H2RA的组合，与SSc-ILD患者生存率改善相关。
方法：纳入来自澳大利亚硬皮病队列研究（ASCS）的SSc患者。GORD被定义为自我报告的GORD症状，使用质子泵抑制剂（PPI）或组胺2受体拮抗剂（H2RA）治疗和/或内镜诊断的反流性食管炎。评估了GORD及其治疗对ILD特征（包括严重程度和ILD发展时间）和生存率的影响。
结果：GORD是影响1539/1632（94％）SSc患者的常见表现。GORD影响了450/469（96％）的SSc-ILD队列。在SSc-ILD中,GORD的存在或其治疗与ILD发展时间或ILD严重程度之间没有关系.然而,GORD治疗与ILD患者生存率改善相关(p=0.002)。PPI和H2RA联合治疗比单独使用PPI的单药治疗具有更大的生存益处（HR分别为0.3vs0.5p<0.050）。
结论：GORD是一种常见的SSc疾病表现。虽然GORD的存在或治疗不会影响ILD的发展或严重程度，积极的GORD治疗，特别是PPI和H2RA的组合，与SSc-ILD患者生存率改善相关。
