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Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease.
Eur Respir J. 2016 Feb; 47(2):588-96.ER

Abstract

Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis. There is lack of clarity around predictors of mortality and disease behaviour over time in these patients.We identified rheumatoid arthritis-related interstitial lung disease (RA-ILD) patients evaluated at National Jewish Health (Denver, CO, USA) from 1995 to 2013 whose baseline high-resolution computed tomography (HRCT) scans showed either a nonspecific interstitial pneumonia (NSIP) or a "definite" or "possible" usual interstitial pneumonia (UIP) pattern. We used univariate, multivariate and longitudinal analytical methods to identify clinical predictors of mortality and to model disease behaviour over time.The cohort included 137 subjects; 108 had UIP on HRCT (RA-UIP) and 29 had NSIP on HRCT (RA-NSIP). Those with RA-UIP had a shorter survival time than those with RA-NSIP (log rank p=0.02). In a model controlling for age, sex, smoking and HRCT pattern, a lower baseline % predicted forced vital capacity (FVC % pred) (HR 1.46; p<0.0001) and a 10% decline in FVC % pred from baseline to any time during follow up (HR 2.57; p<0.0001) were independently associated with an increased risk of death.Data from this study suggest that in RA-ILD, disease progression and survival differ between subgroups defined by HRCT pattern; however, when controlling for potentially influential variables, pulmonary physiology, but not HRCT pattern, independently predicts mortality.

Authors+Show Affiliations

Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA SolomonJ@NJHealth.org.Division of Radiology, National Jewish Health, Denver, CO, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Division of Rheumatology, University of Colorado School of Medicine, Aurora, CO, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Division of Rheumatology, University of Colorado School of Medicine, Aurora, CO, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Department of Radiology, University of Kentucky, Lexington, KY, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Creighton University School of Medicine, Omaha, NE, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic.Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center, Kumagaya, Japan.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26585429

Citation

Solomon, Joshua J., et al. "Predictors of Mortality in Rheumatoid Arthritis-associated Interstitial Lung Disease." The European Respiratory Journal, vol. 47, no. 2, 2016, pp. 588-96.
Solomon JJ, Chung JH, Cosgrove GP, et al. Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease. Eur Respir J. 2016;47(2):588-96.
Solomon, J. J., Chung, J. H., Cosgrove, G. P., Demoruelle, M. K., Fernandez-Perez, E. R., Fischer, A., Frankel, S. K., Hobbs, S. B., Huie, T. J., Ketzer, J., Mannina, A., Olson, A. L., Russell, G., Tsuchiya, Y., Yunt, Z. X., Zelarney, P. T., Brown, K. K., & Swigris, J. J. (2016). Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease. The European Respiratory Journal, 47(2), 588-96. https://doi.org/10.1183/13993003.00357-2015
Solomon JJ, et al. Predictors of Mortality in Rheumatoid Arthritis-associated Interstitial Lung Disease. Eur Respir J. 2016;47(2):588-96. PubMed PMID: 26585429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease. AU - Solomon,Joshua J, AU - Chung,Jonathan H, AU - Cosgrove,Gregory P, AU - Demoruelle,M Kristen, AU - Fernandez-Perez,Evans R, AU - Fischer,Aryeh, AU - Frankel,Stephen K, AU - Hobbs,Stephen B, AU - Huie,Tristan J, AU - Ketzer,Jill, AU - Mannina,Amar, AU - Olson,Amy L, AU - Russell,Gloria, AU - Tsuchiya,Yutaka, AU - Yunt,Zulma X, AU - Zelarney,Pearlanne T, AU - Brown,Kevin K, AU - Swigris,Jeffrey J, Y1 - 2015/11/19/ PY - 2015/03/04/received PY - 2015/09/20/accepted PY - 2015/11/21/entrez PY - 2015/11/21/pubmed PY - 2016/11/2/medline SP - 588 EP - 96 JF - The European respiratory journal JO - Eur. Respir. J. VL - 47 IS - 2 N2 - Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis. There is lack of clarity around predictors of mortality and disease behaviour over time in these patients.We identified rheumatoid arthritis-related interstitial lung disease (RA-ILD) patients evaluated at National Jewish Health (Denver, CO, USA) from 1995 to 2013 whose baseline high-resolution computed tomography (HRCT) scans showed either a nonspecific interstitial pneumonia (NSIP) or a "definite" or "possible" usual interstitial pneumonia (UIP) pattern. We used univariate, multivariate and longitudinal analytical methods to identify clinical predictors of mortality and to model disease behaviour over time.The cohort included 137 subjects; 108 had UIP on HRCT (RA-UIP) and 29 had NSIP on HRCT (RA-NSIP). Those with RA-UIP had a shorter survival time than those with RA-NSIP (log rank p=0.02). In a model controlling for age, sex, smoking and HRCT pattern, a lower baseline % predicted forced vital capacity (FVC % pred) (HR 1.46; p<0.0001) and a 10% decline in FVC % pred from baseline to any time during follow up (HR 2.57; p<0.0001) were independently associated with an increased risk of death.Data from this study suggest that in RA-ILD, disease progression and survival differ between subgroups defined by HRCT pattern; however, when controlling for potentially influential variables, pulmonary physiology, but not HRCT pattern, independently predicts mortality. SN - 1399-3003 UR - https://www.unboundmedicine.com/medline/citation/26585429/Predictors_of_mortality_in_rheumatoid_arthritis_associated_interstitial_lung_disease_ L2 - http://erj.ersjournals.com/cgi/pmidlookup?view=long&amp;pmid=26585429 DB - PRIME DP - Unbound Medicine ER -