Evidence mapPaperPMID 42583470Full record

ArticleJournal of thoracic disease2026

Association between serum anti-granulocyte-macrophage colony-stimulating factor autoantibodies and nintedanib-induced diarrhea in interstitial lung disease: a retrospective study.

Toru Arai, Masakazu Hiramatsu, Naoko Takeuchi, Takayuki Takimoto, Tomoko Kagawa, Ryota Shintani, Mitsuhiro Moda, Masaki Hirose, Tamaki Nakayama, Yoko Yasui

Abstract read
In one paragraph

Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Toru AraiClinical Research Center, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.ORCID https://orcid.org/0000-0002-2222-0683
Masakazu HiramatsuDepartment of Human Nutrition, Faculty of Human Nutrition, Tokyo Kasei Gakuin University, Tokyo, Japan.
Naoko TakeuchiDepartment of Respiratory Medicine, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.
Takayuki TakimotoClinical Research Center, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.
Tomoko KagawaDepartment of Respiratory Medicine, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.
Ryota ShintaniDepartment of Rehabilitation, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.
Mitsuhiro ModaDepartment of Respiratory Medicine, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.
Masaki HiroseClinical Research Center, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.
Tamaki NakayamaDepartment of Clinical Nutrition, NHO Kinki Chuo Chest Medical Center, Sakai City, Osaka, Japan.
Yoko YasuiDepartment of Nutrition Graduate School of Human Life and Ecology, Osaka Metropolitan University, Osaka City, Japan.

Funding

Wellcome Trust FC001030
6 · The paper itself

Abstract

Background: Idiopathic pulmonary fibrosis (IPF) and non-IPF interstitial lung diseases (ILDs) with progressive pulmonary fibrosis (PPF) are associated with poor prognosis. Nintedanib slows the decline in forced vital capacity (FVC) and improves survival; however, diarrhea is the most common adverse event and often leads to treatment discontinuation. Granulocyte-macrophage colony-stimulating factor (GM-CSF) has protective effects on intestinal epithelial integrity, whereas anti-GM-CSF autoantibodies (GMAb) have been associated with disease activity in inflammatory bowel diseases (IBDs). This study aimed to evaluate the utility of serum GMAb levels as a predictor of nintedanib-induced diarrhea. Methods: Forty-one patients with ILDs treated with nintedanib were included. Diarrhea within 3 months of treatment initiation was retrospectively assessed using structured interviews. Predictive factors were analyzed using univariate and multivariate logistic regression models, including relevant clinical variables. Results: The cohort included 30 male patients with underlying diagnoses of IPF (n=26) and non-IPF ILDs meeting PPF criteria (n=15). Diarrhea within 3 months occurred in 26 patients. Male sex was significantly associated with diarrhea (P=0.036), whereas IPF showed a trend toward association (P=0.096). Serum GMAb levels >0.77 µg/mL were independently associated with diarrhea after adjustment for ILD type, sex, and nintedanib dose normalized by body surface area (BSA, multivariate logistic regression). Conclusions: Elevated serum GMAb levels might serve as a predictor of nintedanib-induced diarrhea. GM-CSF/GMAb-related pathways might be associated with the pathogenesis of nintedanib-induced diarrhea. However, validation with a large-scale study is needed to show the clinical and pathophysiological role of GMAb in the future.

Indexed as

Anti-granulocyte-macrophage colony-stimulating factor autoantibodies (GMAb)diarrheagranulocyte-macrophage colony-stimulating factor (GM-CSF)interstitial lung disease (ILD)nintedanib

Identifiers

PMID42583470
PMCPMC13460136

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.