Keskeiset käsitteet
Older age, male sex, and seropositivity are associated with a higher risk for the usual interstitial pneumonia (UIP) subtype of rheumatoid arthritis-associated interstitial lung disease (RA-ILD), while only seropositivity is linked to the nonspecific interstitial pneumonia (NSIP) subtype.
Tiivistelmä
The study examined the risk factors associated with different subtypes of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) using data from two cohorts in the Mass General Brigham Healthcare system.
The researchers identified 208 patients with RA-ILD and 547 control participants with rheumatoid arthritis (RA) but no ILD. RA-ILD subtypes were determined using high-resolution computed tomography (HRCT) imaging.
The key findings are:
- The RA-UIP subtype, which has the worst prognosis, was associated with older age at RA diagnosis, male sex, and seropositivity.
- The RA-NSIP subtype was significantly associated only with seropositivity.
- Nonfibrotic ILDs were significantly associated with positive smoking status and seropositivity.
- The combination of male sex, seropositivity, and positive smoking status was associated with a nearly sevenfold increased risk for RA-UIP.
The authors suggest that RA-ILD subtypes may have distinct risk factor profiles, emphasizing the importance of understanding RA-ILD disease heterogeneity to inform screening and prognostication strategies.
Tilastot
Older age at RA diagnosis was associated with a higher risk for RA-UIP (OR 1.03 per year, 95% CI 1.01-1.05).
Male sex was associated with a higher risk for RA-UIP (OR 2.15, 95% CI 1.33-3.48).
Seropositivity was associated with a higher risk for RA-UIP (OR 2.08, 95% CI 1.24-3.48) and RA-NSIP (OR 3.21, 95% CI 1.36-7.56).
Positive smoking status was associated with a higher risk for nonfibrotic ILDs (OR 2.81, 95% CI 1.52-5.21).
The combination of male sex, seropositivity, and positive smoking status was associated with a nearly sevenfold increased risk for RA-UIP (OR 6.89, 95% CI 2.41-19.69).
Lainaukset
"These findings suggest that RA-ILD subtypes may have distinct risk factor profiles and emphasize the importance of further efforts to understand RA-ILD disease heterogeneity to inform screening and prognostication strategies."