Interstitial lung disease (ILD), a leading cause of morbidity and mortality in rheumatoid arthritis (RA), is highly prevalent, yet RA-ILD is under-recognized.
To identify clinical risk factors, autoantibodies, and biomarkers associated with the presence of RA-ILD.
Subjects enrolled in BRASS and ACR cohorts were evaluated for ILD. Regression models were used to assess the association between variables of interest and RA-ILD. Receiver operating characteristic curves were generated in BRASS to determine if a combination of clinical risk factors and autoantibodies can identify RA-ILD and if the addition of investigational biomarkers is informative. This combinatorial signature was subsequently tested in ACR.
113 BRASS subjects with clinically-indicated chest CT scans (41% with a spectrum of clinically-evident and subclinical RA-ILD) and 76 ACR subjects with research or clinical scans (51% with a spectrum of RA-ILD) were selected. A combination of age, gender, smoking, rheumatoid factor, and anti-cyclic citrullinated peptide antibodies was strongly associated with RA-ILD (AUCs 0.88/BRASS and 0.89/ACR). Importantly a combinatorial signature including MMP7, PARC, and SP-D significantly increased the AUCs to 0.97 (p=0.002/BRASS) and 1.00 (p=0.016/ACR). Similar trends were seen for both clinically-evident and subclinical RA-ILD.
Clinical risk factors and autoantibodies are strongly associated with the presence of clinically-evident and subclinical RA-ILD on CT scan in two independent RA cohorts. A biomarker signature composed of MMP7, PARC, and SP-D significantly strengthens this association. These findings may facilitate identification of RA-ILD at an earlier stage, potentially leading to decreased morbidity and mortality.
This research output has an Altmetric Attention Score of 198. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 February 2021.
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