Treatment Efficacy
In AZA group, 10 patients discontinued their treatment before 6 months
and four patients had incomplete data, leaving 43 patients for the final
analysis. Seven patients in CYC group had missing data and 72 patients
were included in the final analysis . Treatment outcomes are summarized
in Table 2. Despite favorable baseline parameters, those who received
AZA for induction therapy were significantly more likely to progress in
6 months, in terms of MMRC scores and regression of intensity of
reticulation on HRCT, as well as % predicted FVC. CYC treatment
resulted in 2.41 % increase in FVC, however AZA resulted in 1.44%
decline in FVC predicted (p=0.041). These findings remained consistent
after adjustment for age, gender and HRCT pattern, CTD diagnosis,
smoking status, corticosteroid use, disease extent and duration of
symptoms. Progression was more frequent in AZA group across all disease
subtypes. After adjusting for potential confounding factors (age,
disease subtype and basal FVC), a multivariate regression model was
created. The analysis showed that CYC treatment was associated with
decreased risk of progression compared to AZA treatment (HR: 0.18 (95 %
CI 0.05 to 0.542)). Propensity score was used to explain the differences
between patient groups receiving AZA and CYC. The variables used in the
calculation for patients are: age, gender, smoking status, pre-treatment
FVC percent and disease subtype (SCL / non-SCL). According to the
propensity score matching status, a total of 65 patients, 28 AZA and 37
CYC, were selected.After this calculation AZA treatment was related to
increased risk of progression compared to CYC treatment (HR: 6.75 (95 CI
%, 1.97 to 23.12))