Efficacy and safety of pharmacological treatments for autoimmune disease-associated interstitial lung disease: A systematic review and network meta-analysis
Authors' conclusion
MMF, cyclophosphamide, rituximab, tocilizumab, nintedanib and pirfenidone are effective in the treatment of autoimmune disease-associated ILD.
Study context
- Population
- Patients with autoimmune disease-associated interstitial lung disease (ILD) in randomized controlled trials (RCTs) (searched from inception to July 2023)
- Participants
- 1,832 patients15 RCTs
- Comparison
- Pharmacological treatments vs placebo
- Outcome
- Primary outcomes: FVC% predicted and discontinuations for AEs
Methodological detailsfixed-effects network meta-analysis
- Fixed-effects network meta-analysis
Pooled result
As reported in the abstract
FVC% predicted
Each group vs placeboMD (95 % CrI)
MMF
1.27(0.08–2.43)
Cyclophosphamide
1.89(0.10–3.68)
Rituximab
9.29(2.79–15.80)
Tocilizumab
6.30(3.27–9.34)
Nintedanib
1.71(0.54–2.88)
Pirfenidone
2.03(0.65–3.40)
Nintedanib+MMF
2.43(0.95–3.89)
Safety
| Outcome | OR (95 % CrI) | |
|---|---|---|
| Discontinuations for AEs (co-primary)Nintedanibvs PlaceboCrI | 2.09 (1.20–3.73) | |
| Discontinuations for AEs (co-primary)Pirfenidonevs PlaceboCrI | 3.46 (1.31–10.56) | |
| 0.050.21520Odds ratio (log scale) |
- Discontinuations for adverse events (AEs) (co-primary): 95% CrI
Discontinuations for AEs (co-primary)
- Nintedanib+mycophenolate mofetil (MMF) did not increase the risk of AEs vs nintedanib monotherapy
Original publication
Efficacy and safety of pharmacological treatments for autoimmune disease-associated interstitial lung disease: A systematic review and network meta-analysis. Semin Arthritis Rheum. Published 27 June 2024. doi:10.
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