{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T08:24:25Z","timestamp":1787387065986,"version":"build-2736575974"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Noncommunicable Chronic Diseases and National Science and Technology Major Project","award":["2025ZD0549200"],"award-info":[{"award-number":["2025ZD0549200"]}]},{"name":"Guangzhou Health Science and Technology Project","award":["20231A011080"],"award-info":[{"award-number":["20231A011080"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is a lethal condition with mortality exceeding 50% at 3 months, driven by hyperinflammation. Elevated interleukin-6 (IL-6) is associated with poor outcomes. Tocilizumab (TCZ), an IL-6 receptor antagonist, may modulate this harmful inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the efficacy and safety of tocilizumab combined with corticosteroids in AE-IPF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective, propensity score-matched, case-control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-nine AE-IPF patients from a registry (NCT03666234) were included. Thirteen received tocilizumab (8 mg\/kg) plus methylprednisolone, matched 1:2 to 26 receiving conventional therapy. The primary outcome was 3-month all-cause mortality or lung transplantation. Secondary outcomes included changes in ground-glass opacity (GGO) scores and inflammatory biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Baseline characteristics were balanced. A GGO score \u226518 predicted higher mortality (HR 5.01, 95% CI 1.47\u201317.14; p=0.01). In univariable analysis, TCZ was associated with a lower but non-significant risk of the 90-day composite endpoint compared with conventional therapy (unadjusted HR 0.39, 95% CI 0.13\u20131.18; p=0.095). In an exploratory multivariable Cox model adjusting for baseline GGO score and inflammatory markers, TCZ was associated with a significant risk reduction (adjusted HR 0.20, 95% CI 0.05\u20130.72; p=0.014). In exploratory subgroup analyses, TCZ was associated with marked risk reductions in high-risk subgroups: GGO score \u226518 (HR 0.07, 95% CI 0.01\u20130.36; p=0.002), moderate oxygenation impairment (HR 0.12, 95% CI 0.02\u20131.00; p=0.05), and elevated inflammatory markers (HR 0.26, 95% CI 0.08\u20130.82; p=0.021). Tocilizumab also reduced GGO scores (p=0.009). Severe infections occurred in 23.1% (3\/13) of the tocilizumab group between post-treatment days 12 and 30.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this small, propensity-matched cohort, while the primary unadjusted analysis did not reach statistical significance, multivariable adjustment revealed a significant survival benefit signal associated with TCZ, particularly in patients with extensive ground-glass opacities or hyperinflammation. These findings suggest that TCZ may offer clinical advantages for specific high-risk AE-IPF subgroups, warranting validation in larger prospective trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261480225","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:30:31Z","timestamp":1787236231000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tocilizumab for the treatment of acute exacerbation of idiopathic pulmonary fibrosis: A matched case-control retrospective study"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8205-0321","authenticated-orcid":false,"given":"Bingpeng","family":"Guo","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Guangzhou Medical University"},{"name":"Nanfang Hospital"},{"name":"Southern Medical 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