Risk factors for interstitial lung disease in rheumatoid arthritis: a cohort study from the KOBIO registry

被引:2
作者
Min, Hong Ki [1 ]
Kim, Se Hee [1 ,2 ]
Lee, Sang-Heon [3 ]
Kim, Hae-Rim [4 ]
机构
[1] Konkuk Univ, Med Ctr, Dept Internal Med, Div Rheumatol, Seoul, South Korea
[2] Kyung Hee Univ, Kyung Hee Univ Hosp Gangdong, Coll Med, Dept Rheumatol, Seoul, South Korea
[3] Konkuk Univ, Sch Med, Res Inst Med Sci, Div Rheumatol,Dept Internal Med,Med Ctr, Seoul, South Korea
[4] Konkuk Univ, Sch Med, Med Ctr, Div Rheumatol,Dept Internal Med,Res Inst Med Sci, 120-1 Neungdong Ro, Seoul, South Korea
基金
新加坡国家研究基金会;
关键词
biologics; DAS28; DMARDs; interstitial lung disease; rheumatoid arthritis; rheumatoid factor; AMERICAN-COLLEGE; EPIDEMIOLOGY; ABATACEPT; EVENTS;
D O I
10.1177/1759720X231218098
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Interstitial lung disease (ILD) is a critical extra-articular manifestation of rheumatoid arthritis (RA). However, little is known about the risk factors of RA-ILD.Objectives: Here, we examined the effect of demographic, clinical, therapeutic, and environmental factors on the incidence of ILD in RA patients using the Korean College of Rheumatology Biologics and Targeted Therapy (KOBIO) registry.Design: We used data from the KOBIO registry, a multi-center, prospective, observational cohort that included RA patients in South Korea.Methods: RA patients who used biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) or conventional synthetic (cs)DMARDs, and were enrolled in the KOBIO registry, were examined. Demographic, clinical, and radiographic characteristics, as well as medications, were recorded at baseline and annually thereafter. Kaplan-Meier curves and the log-rank test were used to compare the incidence of ILD between RA patients taking different b/tsDMARDs. Hazard ratios (HRs) were calculated by Cox regression analyses.Results: In total, 2492 patients (1967 in the b/tsDMARDs group and 525 in the csDMARDs group) were analyzed. The b/tsDMARDs group showed longer disease duration, higher erythrocyte sedimentation rate/C-reactive protein, and higher disease activity score-28 (DAS28) than the csDMARDs group. The incidence of ILD was significantly higher in those taking tumor necrosis factor inhibitors and abatacept than in those taking csDMARDs (log ranked p < 0.001). Multivariate Cox regression analysis identified older age (HR = 1.057, p = 0.001), male sex (HR = 2.824, p = 0.007), time-averaged DAS28 (HR = 2.241, p < 0.001), and rheumatoid factor titer (HR = 1.009, p = 0.007) as having a significantly increased HR for ILD occurrence.Conclusion: ILD is a rare but critical extra-articular symptom of RA patients. Therefore, RA patients with the above risk factors should be monitored carefully for ILD development.
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页数:12
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