Risk factors for rheumatoid arthritis-associated interstitial lung disease: a retrospective study.

IF 2 Q3 RESPIRATORY SYSTEM

Multidisciplinary Respiratory Medicine Pub Date : 2022-01-12 DOI:10.4081/mrm.2022.877

Aicha Ben Tekaya, Salma Mokaddem, Selma Athimini, Hela Kamoun, Ines Mahmoud, Leila Abdelmoula

{"title":"Risk factors for rheumatoid arthritis-associated interstitial lung disease: a retrospective study.","authors":"Aicha Ben Tekaya, Salma Mokaddem, Selma Athimini, Hela Kamoun, Ines Mahmoud, Leila Abdelmoula","doi":"10.4081/mrm.2022.877","DOIUrl":null,"url":null,"abstract":"Background: The objective of this study was to assess clinical and imaging features of rheumatoid arthritis (RA) associated with interstitial lung disease (ILD), (RA-ILD) group, in comparison to RA without ILD (RA-C) and to identify the associated factors to ILD.Methods: This was a retrospective comparative study (from June 2015 to March 2022) including RA patients aged ≥18 years. The RA-C control group was matched according to age (±2 years), gender, and RA duration (±2 years). General data, RA characteristics, ILD features, and treatment modalities were recorded. Statistical analysis was performed to determine the predictive factors of ILD.Results: A total of 104 patients were included (52 RA-ILD and 52 RA-C); sex ratio was 0.36. Mean age was 66.3±11 years (RA-ILD) versus 65.6±10.8 years (RA-C) (p=0.72). In comparison to RA-C, RA-ILD patients were significantly higher smokers (p=0.01) and physically inactive (p=0.01). Regarding RA features, RA-ILD patients have significantly increased positive anti-citrullinated peptide antibody (ACPA) (p=0.01), ACPA rate (p<0.001), erosive disease (p<0.001), and disease activity score (p<0.001). Mean time to ILD diagnosis was 5.85±7.16 years. Chest high-resolution computed tomography (HRCT) patterns of disease were identified: nonspecific interstitial pneumonia (NSIP) (28.8%), usual interstitial pneumonia (UIP) (17.3%), organizing pneumonia (OP) (25%), acute interstitial pneumonia (13.5%), and respiratory bronchiolitis (3.8%). Multivariate analysis identified smoking, high baseline DAS28 (disease activity score 28) and ACPA positivity as predictive factors of ILD.Conclusion: Our results confirmed the reported associated factors of ILD in RA (smoking, higher disease activity, ACPA positivity). Thus, we need to target the modifiable factors by supporting and educating RA patients to quit smoking and intensify disease modifying anti-rheumatoid drugs (DMARD) to reach remission.","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"17 ","pages":"877"},"PeriodicalIF":2.0000,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/f5/mrm-17-1-877.PMC9728125.pdf","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Multidisciplinary Respiratory Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4081/mrm.2022.877","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 4

Abstract

Background: The objective of this study was to assess clinical and imaging features of rheumatoid arthritis (RA) associated with interstitial lung disease (ILD), (RA-ILD) group, in comparison to RA without ILD (RA-C) and to identify the associated factors to ILD.

Methods: This was a retrospective comparative study (from June 2015 to March 2022) including RA patients aged ≥18 years. The RA-C control group was matched according to age (±2 years), gender, and RA duration (±2 years). General data, RA characteristics, ILD features, and treatment modalities were recorded. Statistical analysis was performed to determine the predictive factors of ILD.

Results: A total of 104 patients were included (52 RA-ILD and 52 RA-C); sex ratio was 0.36. Mean age was 66.3±11 years (RA-ILD) versus 65.6±10.8 years (RA-C) (p=0.72). In comparison to RA-C, RA-ILD patients were significantly higher smokers (p=0.01) and physically inactive (p=0.01). Regarding RA features, RA-ILD patients have significantly increased positive anti-citrullinated peptide antibody (ACPA) (p=0.01), ACPA rate (p<0.001), erosive disease (p<0.001), and disease activity score (p<0.001). Mean time to ILD diagnosis was 5.85±7.16 years. Chest high-resolution computed tomography (HRCT) patterns of disease were identified: nonspecific interstitial pneumonia (NSIP) (28.8%), usual interstitial pneumonia (UIP) (17.3%), organizing pneumonia (OP) (25%), acute interstitial pneumonia (13.5%), and respiratory bronchiolitis (3.8%). Multivariate analysis identified smoking, high baseline DAS28 (disease activity score 28) and ACPA positivity as predictive factors of ILD.

Conclusion: Our results confirmed the reported associated factors of ILD in RA (smoking, higher disease activity, ACPA positivity). Thus, we need to target the modifiable factors by supporting and educating RA patients to quit smoking and intensify disease modifying anti-rheumatoid drugs (DMARD) to reach remission.

查看原文本刊更多论文

类风湿关节炎相关间质性肺疾病的危险因素:一项回顾性研究

背景:本研究的目的是评估类风湿性关节炎(RA)合并间质性肺疾病(ILD) (RA-ILD)组的临床和影像学特征，并与不伴有间质性肺疾病(RA- c)的类风湿关节炎(RA)进行比较，并确定ILD的相关因素。方法:这是一项回顾性比较研究(2015年6月至2022年3月)，纳入年龄≥18岁的RA患者。RA- c对照组根据年龄(±2岁)、性别、RA病程(±2年)进行匹配。记录一般资料、RA特征、ILD特征和治疗方式。通过统计学分析确定ILD的预测因素。结果:共纳入104例患者(52例RA-ILD和52例RA-C);性别比为0.36。平均年龄分别为66.3±11岁(RA-ILD)和65.6±10.8岁(RA-C) (p=0.72)。与RA-C相比，RA-ILD患者吸烟(p=0.01)和不运动(p=0.01)的比例明显高于RA-C。在RA特征方面，RA-ILD患者抗瓜氨酸肽抗体(ACPA)阳性(p=0.01)和ACPA阳性率显著升高(p=0.01)。结论:我们的结果证实了报道的RA中ILD的相关因素(吸烟、疾病活动性高、ACPA阳性)。因此，我们需要通过支持和教育RA患者戒烟和强化疾病修饰类风湿性药物(DMARD)来瞄准可改变的因素，以达到缓解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Multidisciplinary Respiratory Medicine 医学-呼吸系统

CiteScore

4.40

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Multidisciplinary Respiratory Medicine is the official journal of the Italian Respiratory Society - Società Italiana di Pneumologia (IRS/SIP). The journal publishes on all aspects of respiratory medicine and related fields, with a particular focus on interdisciplinary and translational research. The interdisciplinary nature of the journal provides a unique opportunity for researchers, clinicians and healthcare professionals across specialties to collaborate and exchange information. The journal provides a high visibility platform for the publication and dissemination of top quality original scientific articles, reviews and important position papers documenting clinical and experimental advances.