Optimal glucocorticoid tapering in anti-synthetase syndrome-associated interstitial lung disease: A multicentre MYKO cohort study
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ID: 313558
2026
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Abstract
Abstract Objectives To explore glucocorticoid (GC) tapering target in patients with acute/subacute anti-synthetase syndrome–associated interstitial lung disease (ASyS-ILD). Methods We retrospectively analysed 86 patients with newly diagnosed acute/subacute ASyS-ILD from the MYKO cohort. Patients were grouped using prednisolone-equivalent dose thresholds of 15, 12.5, and 10 mg/day at 6 months. Exploratory three-group analyses categorised patients into ≤12.5, 12.5–15, and >15 mg/day. Matching weights adjusted for baseline confounders. Cox proportional-hazards models evaluated 5-year all-cause mortality and event-free survival for disease flares and infections requiring hospitalisation. A multivariable logistic regression assessed factors associated with achieving ≤15 mg/day at 6 months. Results In two-group analyses, the ≤15 mg/day group had a lower infection risk (hazard ratio (HR) 0.18, 95% confidence interval (CI) 0.04–0.81), whereas analyses using other thresholds showed no clear differences. In the three-group analyses, patients receiving 12.5–15 mg/day tended to have the lowest flare risk. Female sex was associated with achieving ≤15 mg/day at 6 months (odds ratio 3.29, 95% CI 1.09–10.13). Conclusions Tapering to a prednisolone-equivalent dose of 12.5–15 mg/day at 6 months may represent a reasonable target to balance risks of flares and infections in patients with acute/subacute ASyS-ILD.
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| Authors | Hirofumi Miyake, Takuya Kotani, Takayasu Suzuka, Shogo Matsuda, Katsumasa Oe, Mahiro Yamamoto, C. Akiyama, Takahiro Seno, Takashi Kida, Tomoya Sagawa, Hironori Inoue, Junya Kitai, Yuki Shimada, Keisuke Hirobe, Kazuma Yoshida, Atsubumi Ogawa, Yuto Nakakubo, Yoichi Nakayama, Y. Nohda, Tsuneo Sasai, Hideaki Tsuji, Ran Nakashima |
| Journal | modern rheumatology |
| Year | 2026 |
| DOI |
10.1093/mr/roag044
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| URL | |
| Keywords | Keywords not found |
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