한빛사논문
- 조회353
Hayoung Choi, MD, PhD1∗, Kyungdo Han, PhD2∗, Jin Hyung Jung, PhD3, Junhee Park, MD4, Bo-Guen Kim, MD5, Bumhee Yang, MD, PhD6, Yeonghee Eun, MD, PhD7, Hyungjin Kim, MD, PhD8,9, Dong Wook Shin, MD, PhD10†, Hyun Lee, MD, PhD11†
1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
2Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
3Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
4Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
5Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
7Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
8Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
9Department of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
10Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Clinical Research Design and Evaluation/Department of Digital Health, Samsung Advanced Institute for Health Science and Technology (SAIHST), Sungkyunkwan University, 81 Irwon-Ro, Gangnam-gu, Seoul 06351, Republic of Korea
11Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
∗ H.C. and K.H. contributed equally to this work.
† D.W.S. and H.L. contributed equally to this work.
Abstract
Background
Despite the coexistence of bronchiectasis and rheumatoid arthritis (RA) and the poor prognosis associated with the combination of conditions, no longitudinal studies that comprehensively evaluated whether patients with RA have a higher risk of bronchiectasis compared with those without bronchiectasis have been published. Whether seropositivity is associated with an increased risk of bronchiectasis in RA is the subject of ongoing controversy.
Research Question
Does RA influence the development of bronchiectasis? Is seropositivity associated with an increased risk of bronchiectasis in RA?
Study Design and Methods
The incidence of bronchiectasis was compared between individuals with RA (n=50,651; 35,879 seropositive RA [SPRA] and 14,772 seronegative RA [SNRA]) and 1:5 age- and sex-matched controls (n=253,255) enrolled between 2010 and 2017 in the Korean National Health Insurance Service database. The participants were followed from 1 year after RA diagnosis or the corresponding index date to the date of bronchiectasis incidence, censored date, or December 2019.
Results
The cumulative incidence of bronchiectasis at 9 years of follow-up was approximately 7% in participants with RA. During a median follow-up of 4.3 years (interquartile range, 2.6–6.3 years), participants with RA showed a 2.12-fold higher risk of developing bronchiectasis compared with matched controls even after adjusting for potential confounders related to bronchiectasis development (95% confidence interval [CI], 2.00–2.25), In an analysis of RA serologic status using a fully adjusted model, participants with SPRA and those with SNRA showed 2.34-fold (95% CI, 2.20–2.49) and 1.56-fold (95% CI, 1.40–1.73) increased risks, respectively, compared with matched controls.
Interpretation
Individuals with RA had approximately twice the risk of developing bronchiectasis than matched controls even after adjusting for potential confounders. The increased risk was more evident in individuals with SPRA than in those with SNRA, implying that rheumatic inflammation plays a major role in the development of RA-bronchiectasis.
논문정보
- Research article
- 2024년 01월 (BRIC 등록일 2024-01-05)
- 국내 연구진
- 의약학 > 응용의학
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