%0 Journal Article %A Li Fan %A Wenting Lyu %A Huarui Liu %A Hanyi Jiang %A Lulu Chen %A Yin Liu %A Yi Zhuang %A Mei Huang %A Min Cao %A Hourong Cai %A Yonglong Xiao %A Jinghong Dai %T A Retrospective Analysis of Outcome in Melanoma Differentiation–Associated Gene 5–Related Interstitial Lung Disease Treated with Tofacitinib or Tacrolimus %D 2022 %R 10.3899/jrheum.220367 %J The Journal of Rheumatology %P jrheum.220367 %X Objective The efficacy of tofacitinib (TOF) in the early diagnosis of melanoma differentiation–associated gene 5 (MDA5)–related interstitial lung disease (ILD) has been described. However, whether TOF exposure is associated with a reduced 1-year mortality rate remains undetermined. Methods Patients diagnosed with MDA5-ILD receiving TOF or tacrolimus (TAC) treatment were included. A Cox proportional hazards model, which was adjusted for age, sex, smoking history, anti-MDA5 antibody titers, and concurrent use of other steroid-sparing agents, was performed to compare all-cause mortality and to investigate the risk factors predicting 1-year mortality rates in the 2 treatment groups. Results During the study period, 26 patients were treated with TOF and 35 were treated with TAC. The 6-month (38.5% vs 62.9%; P = 0.03) and 1-year (44.0% vs 65.7%; P = 0.03) mortality rates in the TOF group were significantly lower than those in the TAC group. There were 13 patients diagnosed with rapidly progressive ILD (RP-ILD) in the TOF group and 22 in the TAC group. The majority of deaths occurred in patients with RP-ILD. The 6-month (76.9% vs 95.5%; P = 0.02) and 1-year (84.6% vs 100.0%; P = 0.02) mortality rates of patients with RP-ILD in the TOF group were also lower than those in the TAC group, respectively. The adjusted model showed that TOF exposure was associated with a lower risk for 1-year mortality (hazard ratio 0.44, 95% CI 0.20-0.96; P = 0.04). However, the incidence of adverse events (73.1% vs 74.3%; P > 0.99) and medication discontinuation rates (23.1% vs 14.3%; P = 0.50) in the TOF and TAC groups were similar, respectively. Conclusion Our observational study showed that TOF use might have a potential effect on improving the outcomes of MDA5-ILD. Future clinical trials are needed to assess the long-term efficacy and tolerability of TOF. %U https://www.jrheum.org/content/jrheum/early/2022/10/10/jrheum.220367.full.pdf