Clinical application of combined anticoagulation therapy in anti-MDA5 antibody-positive associated interstitial lung...

To explore the clinical efficacy of combined anticoagulation therapy in patients with anti-Melanoma Differentiation-Associated protein 5 (MDA5) antibody-positive associated interstitial lung disease.

A retrospective cohort study was conducted, which included 100 patients diagnosed with anti-MDA5 antibody-positive interstitial lung disease at our hospital between January 2022 and December 2024. Based on the treatment approach, the patients were divided into two groups: the combined anticoagulation group (receiving conventional therapy plus sequential low-molecular-weight heparin followed by rivaroxaban) and the control group (receiving conventional therapy only). Comparisons were made between the two groups regarding pulmonary function parameters (FVC%, DLCO%, PaO₂), inflammatory markers (CRP, ESR, LDH, CK), as well as the incidence of complications and acute exacerbations. Furthermore, logistic regression analysis was employed to identify independent risk factors for acute exacerbations.

At 4-week treatment and 3-month follow-up, the combined anticoagulation group had superior Forced Vital Capacity (FVC)%, Diffusing Capacity of the Lung for Carbon Monoxide (DLCO)%, and Arterial Partial Pressure of Oxygen (PaO₂) levels compared to the control group (P < 0.05). Meanwhile, C-Reactive Protein (CRP), Lactate Dehydrogenase (LDH), and Creatine Kinase (CK) levels decreased significantly. Also, the incidence of complications and acute exacerbation was lower in the combined group (P < 0.05). Logistic regression showed decreased PaO₂, elevated CRP, LDH, and CK, fungal infection, abnormal liver/kidney function, and non-combined anticoagulation as independent acute-exacerbation risk factors.

Combined anticoagulation therapy improves pulmonary function, reduces inflammation, and lowers complication and exacerbation risks in anti-MDA5 antibody-positive interstitial lung disease patients. With notable clinical value, it offers a new treatment strategy for this refractory disease.