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A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: Comorbidity and mortality

Annals of Rheumatic Diseases Sep 23, 2017

Hyldgaard C, et al. - The mortality risks in patients with rheumatoid arthritis-related interstitial lung disease (RA-ILD) and patients with RA without ILD are compared in this study. ILD is a serious complication in RA, with a significantly increased mortality compared with a large matched cohort of RA comparisons without ILD.

Methods

  • For this research, they designed a matched cohort study.
  • By using nationwide, prospectively collected data, they conducted this study in Denmark.
  • Among patients with RA diagnosed between 2004 and 2016, 679 patients with RA-ILD were matched for birth year, gender and age at RA diagnosis with 11722 patients with RA but without ILD.

Results

  • The number of prevalent RA patients more than doubled from 15352 to 35362 individuals during the study period.
  • RA-ILD was seen in 2.2% of incident RA patients. 34.0% of RA-ILD cases were diagnosed within 1 year prior to and 1 year after the RA diagnosis.
  • One-year mortality was 13.9% (95% CI, 11.4% to 16.7%) in RA-ILD and 3.8% (95% CI, 3.5% to 4.2%) in non-ILD RA, 5-year mortality was 39.0% (34.4% to 43.5%) and 18.2% (17.3% to 19.1%) and 10-year mortality was 60.1% (52.9% to 66.5%) and 34.5% (32.8% to 36.1%), respectively.
  • The HRRs for death were 2 to 10 times increased for RA-ILD compared with non-ILD RA, irrespective of follow-up period.
  • Stratified investigation demonstrated that the HRR for death was highest in the first months after the diagnosis of RA-ILD was made, particularly in patients diagnosed with RA before diagnosis of ILD.
  • HRR was higher in males and in patients without comorbidity as evaluated by the Charlson Comorbidity Index.

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