RT Journal Article
SR Electronic
T1 Demographic, Lifestyle, and Serologic Risk Factors for Rheumatoid Arthritis (RA)–associated Bronchiectasis: Role of RA-related Autoantibodies
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.211242
DO 10.3899/jrheum.211242
A1 McDermott, Gregory
A1 Gill, Ritu
A1 Gagne, Staci
A1 Byrne, Suzanne
A1 Huang, Weixing
A1 Wang, Xiaosong
A1 Prisco, Lauren C.
A1 Zaccardelli, Alessandra
A1 Martin, Lily W.
A1 Masto, Lucy
A1 Kronzer, Vanessa L.
A1 Shadick, Nancy
A1 Dellaripa, Paul F.
A1 Doyle, Tracy J.
A1 Sparks, Jeffrey A.
YR 2022
UL http://www.jrheum.org/content/early/2022/05/10/jrheum.211242.abstract
AB Objective To investigate demographic, lifestyle, and serologic risk factors for isolated rheumatoid arthritis (RA)–associated bronchiectasis (RA-BR) that is not a result of interstitial lung disease (ILD). Methods We performed a case-control study using patients with RA from the Mass General Brigham Biobank. We reviewed the records of all patients with RA meeting the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology criteria with computed tomography (CT) chest imaging to identify RA-BR cases and controls with RA and RA-related lung disease. For each patient, the CT chest imaging that was performed closest to enrollment was independently reviewed by 2 radiologists for the presence of RA-related lung diseases. Cases had clinical and radiologic evidence of RA-BR without interstitial lung abnormalities on imaging. Controls had RA and no evidence of bronchiectasis or ILD. We examined the associations between demographic, lifestyle, and serologic factors with RA-BR using multivariable logistic regression. Results We identified 57 cases of isolated RA-BR and 360 RA controls without RA-related lung disease. In multivariable models, RA-BR was associated with older age at RA onset (OR 1.37 per 10 years, 95% CI 1.02–1.82), lower BMI at RA diagnosis (OR 0.94 per kg/m2, 95% CI 0.89–0.99), seropositive RA (OR 3.96, 95% CI 1.84–8.53), positive rheumatoid factor (OR 4.40, 95% CI 2.14–9.07), and positive anticyclic citrullinated peptide (OR 3.47, 95% CI 1.65–7.31). Higher titers of RA-related autoantibodies were associated with higher odds of RA-BR. Conclusion Seropositivity, older age at RA diagnosis, and lower BMI at RA onset were associated with isolated bronchiectasis in RA that was not a result of ILD. These findings expand the list of potential risk factors for RA-BR and suggest a pathogenic link between airway inflammation and RA-related autoantibodies.