Abstract
Introduction: Systemic sclerosis associated interstitial lung disease (SSc-ILD) is a leading cause of morbidity and mortality in SSc. Precise measures to identify SSc-ILD and assist risk-stratification are lacking.
Aim: Investigate composite serum biomarker panels for SSc-ILD diagnosis.
Methods: 28 biomarkers were analysed in 640 participants from two national longitudinal cohorts:259 SSc-ILD, 179 SSc-controls without ILD, 172 IPF-controls, and 30 healthy controls. A composite index was developed from biomarkers associated with fibrotic lung disease in multivariable analysis derived at empirical thresholds. Performance of the index to identify fibrotic lung disease and SSc-ILD, its association with physiology, quality of life and transplant free survival (TFS) were evaluated in derivation and validation cohorts. Biomarkers to distinguish SSc-ILD from IPF-controls were identified.
Results: A composite biomarker index, comprising SP-D, Ca15-3 and ICAM-1, was strongly associated with SSc-ILD diagnosis, independent of age, sex, smoking and lung function (index=3: pooled adj. OR 12·72, p<0·001). The index strengthened the performance of individual biomarkers for SSc-ILD identification. In SSc patients, a higher biomarker index was associated with worse baseline disease severity (index=3 relative to index=0: adjusted absolute change in FVC% –17·84% and DLCO% –20·16%, both p<0·001) and TFS (index=3: pooled adj. HR 2·27, p=0·043). TGF-b1 and CXCL-10 discriminated SSc-ILD from IPF.
Conclusion: A composite serum biomarker index, comprising SP-D, Ca15-3, ICAM-1, may improve the identification and severity assessment of SSc-ILD at baseline.
Footnotes
Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, OA2976.
This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2021