275. FACTORS ASSOCIATED WITH DISEASE PROGRESSION IN PATIENTS WITH MYELOPEROXIDASE-ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-RELATED PULMONARY FIBROSIS
Bibliographic record
Abstract
Background: Fibrotic interstitial lung disease (ILD) is an established finding in patients with ANCA- associated vasculitis (AAV) with an observed prevalence of 23-45% with a preponderance in patients with microscopic polyangiitis (MPA).1,2 The presence of ILD in patients with AAV appears to be associated with a poor prognosis and reduced survival.3,4 However, the factors associated with the progression of fibrosis or decline in pulmonary function, including systemic treatment, have not been well characterized. We aimed to evaluate factors that may be associated with progression of fibrotic ILD from a cohort of patients with AAV. Methods: Patients with a positive serology for myeloperoxidase antibodies (MPO-ANCA) and a diagnosis of AAV were identified retrospectively from a list of outpatients assessed at our center from 2001 to 2018. All CT chest images were reviewed to identify the presence of fibrotic ILD based on the Fleischner Society recommendations.5 The extent of fibrosis was scored using a method modified from Ooi et al.6 Progression of disease was defined as an increase in the fibrosis score of at least 2 (CT progression) or deterioration of FVC > 10% or DLCO > 15% (PFT decline) at any time in the follow-up period. Patients were categorized as “progressors” or “non-progressors” and characteristics and outcomes were determined. Clinical, radiographic, pulmonary function, and outcome data were extracted. Results: We identified 93 patients of whom 20 (21.5%) had radiographic evidence of fibrotic ILD. Of these 20, 8 (40%) demonstrated CT progression while only 3 (15%) patients had PFT decline. The median time to follow-up CT chest and PFT was 3 years (IQR 1-5) and 2 years (1-3) respectively. Age, sex, and baseline FVC appeared similar between patients with or without progression. Patients with CT progression appeared to have lower mean DLCO at baseline (34.7% vs 46.9%). A similar frequency of UIP pattern (50%) and baseline fibrosis score (6.8 – 8.0) was observed in both groups. Finally, the use of cyclophosphamide or azathioprine was similar in the groups comparing fibrosis score but was less common in patients who demonstrated PFT decline. Conclusion: Our data suggests that a low baseline DLCO may suggest a higher chance of ILD progression in AAV. Conversely, the use of cyclophosphamide may correlate with stability of lung function. Finally, CT characteristics may not be predictors of prognosis. These findings identify an opportunity for additional prospective study. Clinical characteristics of groups comparing progression of ILD by PFT changes or lung fibrosis score Clinical characteristics of groups comparing progression of ILD by PFT changes or lung fibrosis score Disclosures: None
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".