@article {Kronzerjrheum.200863, author = {Vanessa L. Kronzer and Weixing Huang and Paul F. Dellaripa and Sicong Huang and Vivi Feathers and Bing Lu and Christine K. Iannaccone and Ritu R. Gill and Hiroto Hatabu and Mizuki Nishino and Cynthia S. Crowson and John M. Davis III and Michael E. Weinblatt and Nancy A. Shadick and Tracy J. Doyle and Jeffrey A. Sparks}, title = {Lifestyle and clinical risk factors for incident rheumatoid arthritis-associated interstitial lung disease}, elocation-id = {jrheum.200863}, year = {2020}, doi = {10.3899/jrheum.200863}, publisher = {The Journal of Rheumatology}, abstract = {Objective To determine the association between novel lifestyle factors on risk of rheumatoid arthritis-associated interstitial lung disease (RA-ILD), define the threshold at which smoking increases RA-ILD risk, and calculate the degree to which known lifestyle and clinical factors predict RA-ILD. Methods This nested case-control study matched incident RA-ILD cases to RA non-ILD controls on age, sex, RA duration, rheumatoid factor, and time from exposure assessment to RA-ILD. Exposures included education, body mass index (BMI), smoking, anti-cyclic citrullinated peptide, race, joint erosions, rheumatoid nodules, C-reactive protein (CRP), disease activity score, functional status, disease-modifying anti-rheumatic drug use, and glucocorticoid use. Odds ratios (OR) for each exposure on risk of RA-ILD were obtained from logistic regression models. Area under the curve (AUC) was calculated based all lifestyle and clinical exposures. Results We identified 84 incident RA-ILD cases and 233 matched controls. After adjustment, obesity, high-positive CRP (>=10 mg/L), and poor functional status (MDHAQ >=1) were associated with increased risk of RA-ILD (OR 2.42, 95\% confidence interval [CI] 1.11-5.24 vs. normal BMI; OR 2.61, 95\% CI 1.21-5.64 vs. CRP \<3mg/L; OR 3.10, 95\% CI 1.32-7.26 vs. MDHAQ \<0.2). Smoking 30 pack-years or more was strongly associated with risk of RA-ILD compared to nonsmokers (OR 6.06, 95\% CI 2.72-13.5). Together, lifestyle and clinical risk factors for RA-ILD had an AUC of 0.79 (95\% CI 0.73-0.85). Conclusion Obesity, CRP, functional status, and extensive smoking may be novel risk factors for RA-ILD, useful for RA-ILD risk assessment and prevention. The overall ability to predict RA-ILD remains modest.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/early/2020/11/10/jrheum.200863}, eprint = {https://www.jrheum.org/content/early/2020/11/10/jrheum.200863.full.pdf}, journal = {The Journal of Rheumatology} }