RESUMEN
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). CONCLUSION: 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.
Asunto(s)
Reflujo Gastroesofágico , Antagonistas de los Receptores H2 de la Histamina , Enfermedades Pulmonares Intersticiales , Inhibidores de la Bomba de Protones , Esclerodermia Sistémica , Humanos , Reflujo Gastroesofágico/tratamiento farmacológico , Reflujo Gastroesofágico/complicaciones , Enfermedades Pulmonares Intersticiales/tratamiento farmacológico , Femenino , Masculino , Persona de Mediana Edad , Esclerodermia Sistémica/complicaciones , Esclerodermia Sistémica/tratamiento farmacológico , Inhibidores de la Bomba de Protones/uso terapéutico , Anciano , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Adulto , Estudios de Cohortes , Resultado del Tratamiento , Australia/epidemiologíaRESUMEN
OBJECTIVES: Cardiovascular events and mortality have shown a higher incidence within the Christmas holiday period in previous studies and in the northern and southern hemisphere. Our study aimed to assess changes in cardiovascular and stroke mortality variation around the Christmas period in Australia. STUDY DESIGN: The study design is a population-based case-control study. METHODS: Daily mortality data attributed to stroke and cardiovascular was compiled from Australia between 1989 and 2015, amounting to approximately 700,000 and 250,000 deaths, respectively. A locally weighted polynomial regression line was used to estimate expected mortality rates during that period and compared with actual results. RESULTS: There was a non-significant increase of 1.08% (P = 0.35) and 0.20% (P = 0.87) for coronary heart disease and stroke mortality, respectively, in the Christmas holiday period. CONCLUSIONS: There is no evidence of an increase in cardiovascular and stroke mortality in the Christmas holiday period in Australia.
