(JM test 2)Early RA-ILD raises mortality risk

Older age and female sex are some of the factors associated with early-onset interstitial lung disease (ILD) in rheumatoid arthritis (RA), reveals a study.

In addition, “[p]atients with early RA-ILD experience increased all-cause and RA-ILD related mortality after adjusting for demographics and comorbidities,” the authors said.

This retrospective observational study utilized health services data from Ontario, Canada and identified RA cases between 2000 and 2020 using the Ontario Rheumatoid Arthritis Database. RA-ILD diagnosis required repeat physician visits for ILD. Early RA-ILD was defined as onset within 1 year of RA diagnosis.

The authors identified the factors associated with early RA-ILD and surgical lung biopsy completion using multivariable logistic regression. They also assessed the relationship of early versus late RA-ILD with all-cause and RA-ILD related mortality via multivariable Cox proportional hazards regression.

A total of 3,717 RA-ILD patients were analysed. Older age at RA diagnosis (odds ratio [OR], 1.04, 95 percent confidence interval [CI], 1.03‒1.05; p<0.0001), female sex (OR, 1.16, 95 percent CI, 1.01‒1.35; p=0.04), and immigrating to Ontario (OR, 1.70, 95 percent CI, 1.35‒2.14; p<0.0001) significantly correlated with early RA-ILD.

The likelihood of undergoing a surgical lung biopsy were similar between patients with early RA-ILD and those with late RA-ILD (OR, 1.34, 95 percent CI, 0.83‒2.16; p=0.23).

Notably, patients with early RA-ILD had a higher risk of all-cause mortality (hazard ratio [HR], 1.17, 95 percent CI, 1.07‒1.29; p=0.0009), which was driven by an increase in RA-ILD related deaths (HR, 1.45, 95 percent CI, 1.19‒1.76; p=0.0003).

“ILD can occur as a manifestation of RA at various times in the disease course,” the authors said.