Bidirectional association of rheumatoid arthritis and inflammatory bowel diseases: a large-scale prospective cohort study.

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2025-06-13 DOI:10.1093/rheumatology/keaf337

Yijun Chen, Qian Zhang, Si Liu, Shengtao Zhu, Jing Wu, Shutian Zhang, Peng Li, Shanshan Wu

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引用次数: 0

Abstract

Objectives: to investigate the bidirectional prospective association between inflammatory bowel disease (IBD) and rheumatoid arthritis (RA) in a large-scale, long-term follow-up, population-based cohort.

Methods: Participants free of any cancer at baseline were included and divided into two prospective cohorts: baseline IBD and incident RA cohort (cohort 1), and baseline RA and incident IBD cohort (cohort 2), respectively. The primary outcome was incident RA in cohort 1 and incident IBD, including ulcerative colitis (UC) and Crohn's disease (CD) in cohort 2, separately. Cox proportional hazard regression models were used to investigate the bidirectional relationship between RA and IBD.

Results: Overall, 449 662 and 450 534 participants were included in cohort 1 and cohort 2, with 5,015/5,887 prevalent IBD/RA cases at baseline, respectively. During a median of 14.3/14.6-year follow-up, 6,001(1.3%)/2,988(0.7%) cases of RA and IBD were identified in each cohort. Compared with non-IBD, IBD patients (HR = 1.44, 95% CI: 1.15-1.79) showed a significantly higher risk of incident RA, particularly in UC patients (HR = 1.36, 95% CI: 1.06-1.75) after multivariable adjustment. Similarly, RA patients had a 1.65-fold higher risk (95% CI: 1.31-2.09) of incident IBD, with a 60% and 65% excess risk of developing UC (HR = 1.60, 95% CI: 1.20-2. 13) and CD (HR = 1.65, 95% CI: 1.12-2. 42), respectively. Further sensitivity analysis and subgroup analysis indicated similar results.

Conclusion: IBD is associated with an increased risk of RA, and vice versa. Further studies are warranted to confirm the findings and elucidate the underlying biological mechanisms.

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类风湿性关节炎和炎症性肠病的双向关联：一项大规模前瞻性队列研究

目的：在一项大规模、长期随访、基于人群的队列研究中，研究炎症性肠病（IBD）和类风湿关节炎（RA）之间的双向前瞻性关联。方法：纳入基线时无任何癌症的参与者，并将其分为两个前瞻性队列：基线IBD和事件RA队列（队列1），基线RA和事件IBD队列（队列2）。主要结局分别是队列1中的RA事件和队列2中的IBD事件，包括溃疡性结肠炎（UC）和克罗恩病（CD）。采用Cox比例风险回归模型探讨RA与IBD之间的双向关系。结果：总体而言，队列1和队列2分别纳入449 662和450 534名参与者，基线时IBD/RA患病率分别为5,015/5,887。在14.3/14.6年的中位随访期间，每个队列中发现了6,001例(1.3%)/2,988例（0.7%）RA和IBD病例。多变量调整后，与非IBD患者相比，IBD患者（HR = 1.44, 95% CI: 1.15-1.79）发生RA的风险明显更高，尤其是UC患者（HR = 1.36, 95% CI: 1.06-1.75）。同样，RA患者发生IBD的风险高出1.65倍（95% CI: 1.31-2.09），发生UC的风险高出60%和65% （HR = 1.60, 95% CI: 1.20-2）。13)和CD （HR = 1.65, 95% CI: 1.12-2）。分别为42)。进一步的敏感性分析和亚组分析显示相似的结果。结论：IBD与RA风险增加相关，反之亦然。需要进一步的研究来证实这些发现并阐明潜在的生物学机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

期刊介绍： Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press. Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.