Analysis of comorbidity in rheumatoid arthritis–associated interstitial lung disease: a nested case-cohort study - 08/12/22
, Marta Rojas-Gimenez c, d, Carmen María Romero-Barco a, e, Myriam Gandía-Martínez f, Nair Perez-Gómez g, Francisco Javier Godoy-Navarrete h, Sara Manrique-Arija a, b, i, Aimara Garcia-Studer a, b, Jerusalem Calvo-Gutiérrez c, d, Clara Fuego Varela f, Pilar Morales-Garrido j, Patricia Castro Pérez k, Coral Mouriño-Rodriguez g, Isabel Añón-Oñate h, Francisco Espildora l, María Carmen Aguilar-Hurtado m, Rocío Redondo a, b, Ana Hidalgo Conde n, Rocío Arnedo Díez de los Ríos n, Eva Cabrera César o, Maria Luisa Velloso-Feijoo p, Antonio Fernández-Nebro a, b, iAbstract |
Objectives |
To describe comorbid conditions in patients with rheumatoid arthritis–associated interstitial lung disease (RA-ILD) and to analyze factors associated with multimorbidity.
Methods |
Nested case-cohort study of 2 prospective cohorts: one with RA-ILD (cases) and another with RA but not ILD (controls). The cohorts were matched for age, sex, and time since diagnosis. Multimorbidity was defined as the co-occurrence of 2 or more chronic diseases, in addition to RA and ILD. We evaluated the comorbid conditions included in the Charlson Comorbidity Index, cardiovascular risk factors, neuropsychiatric conditions, and other frequent conditions in RA. We also recorded clinical-laboratory variables, inflammatory activity according to the 28-joint Disease Activity Score, C-reactive protein (CRP), physical function, and pulmonary function. We performed 2 multivariate analyses to identify factors associated with multimorbidity in RA and RA-ILD.
Results |
The final study population comprised 110 cases and 104 controls. Multimorbidity was more frequent among cases than controls (80 [72.7] vs 60 [57.7]; p = 0.021). In both groups, multimorbidity was associated with ILD (OR [95% CI] 1.92 [1.03–3.59]; p = 0.039), age (OR [95% CI] 1.05 [1.01–1.08]; p = 0.004), CRP (OR [95% CI] 1.16 [1.05–1.29]; p = 0.003), and erosions (OR [95% CI] 1.05 [1.01–1.08]; p = 0.004); in the cases, it was associated with CRP (OR [95% CI] 1.17 [1.01–1.35]; p = 0.027), anti–citrullinated peptide antibody (OR [95% CI] 1.23 [1.14–13.02]; p = 0.049), and forced vital capacity (OR [95% CI] 0.79 [0.96–0.99]; p = 0.036).
Conclusion |
In patients with RA, multimorbidity was associated with ILD, systemic inflammation, and advanced age.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Comorbid conditions are a major cause of morbidity and mortality in patients with rheumatoid arthritis (RA) and patients with interstitial lung disease (ILD). |
• | ILD was independently associated with multimorbidity in patients with RA. |
• | The most frequent comorbid conditions associated with RA-ILD were traditional cardiovascular risk factors, depression, and osteoporosis. |
• | Other factors, such as ACPA titers and elevated CRP levels, were also associated with multimorbidity in cases with RA-ILD. |
Keywords : Rheumatoid arthritis, Interstitial lung disease, Comorbidity, Multimorbidity, Inflammation
Plan
Vol 157
Article 114049- janvier 2023 Retour au numéro
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