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Updated: May 19, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Optimal glucocorticoid tapering in anti-synthetase syndrome-associated interstitial lung disease: A multicentre MYKO
Hirofumi Miyake1, Takuya Kotani2, Takayasu Suzuka2
1Department of General Internal Medicine, Tenri Hospital, Tenri, Japan.
Objectives:
To explore glucocorticoid (GC) tapering target in patients with acute/subacute anti-synthetase syndrome-associated interstitial lung disease (ASyS-ILD).
Methods:
We retrospectively analysed 86 patients with newly diagnosed acute/subacute ASyS-ILD from the MYKO cohort. Patients were grouped using prednisolone-equivalent dose thresholds of 15, 12.5, and 10 mg/day at 6 months. Exploratory three-group analyses categorised patients into ≤12.5, 12.5-15, and >15 mg/day. Matching weights adjusted for baseline confounders. Cox proportional-hazards models evaluated 5-year all-cause mortality and event-free survival for disease flares and infections requiring hospitalisation. A multivariable logistic regression assessed factors associated with achieving ≤15 mg/day at 6 months.
Results:
In two-group analyses, the ≤15 mg/day group had a lower infection risk (hazard ratio (HR) 0.18, 95% confidence interval (CI) 0.04-0.81), whereas analyses using other thresholds showed no clear differences. In the three-group analyses, patients receiving 12.5-15 mg/day tended to have the lowest flare risk. Female sex was associated with achieving ≤15 mg/day at 6 months (odds ratio 3.29, 95% CI 1.09-10.13).
Conclusions:
Tapering to a prednisolone-equivalent dose of 12.5-15 mg/day at 6 months may represent a reasonable target to balance risks of flares and infections in patients with acute/subacute ASyS-ILD.
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