Prevalence and risk factors of bronchiectasis in rheumatoid arthritis: A systematic review and meta-analysis

Martin, Lily; Prisco, Lauren; Huang, Wenxin; McDermott, Gregory; Shadick, Nancy A.; Doyle, Tracy J.

doi:10.1016/j.semarthrit.2021.08.005

Cited by 15 publications

(10 citation statements)

References 52 publications

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“…An in ammatory process in the lungs can provoke autoimmune responses, such as the generation of citrullinated peptide antibodies against antigens released from activated neutrophils [8,13]. In agreement with previous studies reporting a high risk of bronchiectasis in other CTDs such as rheumatoid arthritis and Sjogren's syndrome [30,31], systemic and pulmonary in ammation may coexist and in uence each other in systemic sclerosis, which leads to the development of bronchiectasis. Third, the use of immunosuppressants in systemic sclerosis might be related to recurrent respiratory infection, which is an important cause of bronchiectasis [32].…”

Section: Discussionsupporting

confidence: 83%

Systemic sclerosis and risk of bronchiectasis: A nationwide longitudinal cohort study

Yang

Kim

Jung

et al. 2023

Preprint

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Backgroud: The impact of systemic sclerosis on the development of bronchiectasis is unclear. This study aimed to compare the risk of bronchiectasis between individuals with systemic sclerosis and those without using a nationwide longitudinal dataset. Methods: Using the Korean National Health Insurance Service dataset between 2010 and 2017, we identified 4,845 individuals aged ≥ 20 years with systemic sclerosis and 24,225 without systemic sclerosis who were matched 1:5 by age and sex. They were followed up until the date of a bronchiectasis diagnosis, death, or December 31, 2019, whichever came first. Results: During a median follow-up period of 6.0 (interquartile range, 3.2–8.7) years, 5.3% of the systemic sclerosis cohort and 1.9% of the matched cohort developed bronchiectasis, with incidence rates of 9.99 and 3.23 per 1,000 person-years, respectively. Even after adjusting for potential confounders, the risk of incident bronchiectasis was significantly higher in the systemic sclerosis cohort than in the matched cohort (adjusted hazard ratio 2.63, 95% confidence interval 2.22–3.12). The risk of incident bronchiectasis was notably higher in younger individuals (P for interaction = 0.048) and those with coexisting connective tissue disease (Pfor interaction = 0.005) compared to their counterparts. Conclusions: The risk of incident bronchiectasis is higher in individuals with systemic sclerosis than those without. Bronchiectasis should be considered one of the pulmonary manifestations related to systemic sclerosis.

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Section: Discussionsupporting

confidence: 83%

Systemic sclerosis and risk of bronchiectasis: A nationwide longitudinal cohort study

Yang

Kim

Jung

et al. 2023

Preprint

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“…[ 3 , 33 ] Compared with other connective tissue diseases (CTD), small airway diseases, including bronchiolitis obliterans, follicular bronchiolitis, and bronchiectasis, are more common in RA patients. [ 33 , 34 ] Some patients may have coexisting interstitial and small airways disease or diffuse bronchiectasis in RA [ 35 , 36 ] : a recent meta-analysis showed that the overall prevalence of bronchiectasis is between 18.7% and 22.6% among RA, and bronchiectasis is more common in RA-ILD (18.1%–30.0%) vs. RA without ILD (10.5%–20.0%). As ILD can be the first manifestation of RA, for patients with a UIP and/or NSIP pattern of ILD concomitant with bronchiectasis, screening for RA in the initial diagnostic algorithm and follow-up surveillance is recommended.…”

Section: Ra-associated Ildmentioning

confidence: 99%

Diffuse lung involvement in rheumatoid arthritis: a respiratory physician's perspective

Huang

Chen

Shao

et al. 2023

Chinese Medical Journal

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The lungs are one of the most common extra-articular organs involved in rheumatoid arthritis (RA), which is reported to occur in up to 60% to 80% of RA patients. Respiratory complications are the second leading cause of death due to RA. Although there is a wide spectrum of RA-associated respiratory diseases, interstitial lung disease is the most common manifestation and it impacts the prognosis of RA. There has been progress in understanding the management and progression of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and RA-associated respiratory diseases recently, for example, opportunistic pulmonary infectious diseases and toxicity from RA therapies. From a chest physicians' perspective, we will update the diagnosis and treatment of RA-associated ILD, methotrexate-associated lung disease, and the complication of Pneumocystis jiroveci pneumonia in RA in this review.

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“…The most common extra-articular manifestation of RA is lung involvement, which can affect up to 60% of patients with RA during the disease course [3]. Bronchiectasis is an established extraarticular manifestation of RA, which presents as irreversible damage to the bronchi along with widening and thickening resulting in exuberant mucus production [4]. Approximately 30% of RA patients demonstrate bronchiectasis on High-Resolution Computed Tomography, which can be asymptomatic and may precede or follow the development of RA [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Causal relationship between rheumatoid arthritis and bronchiectasis: A bidirectional Mendelian randomization study

Chen,

Li,

Shi

et al. 2024

Preprint

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Background Epidemiological observational studies have elucidated a correlation between rheumatoid arthritis (RA) and bronchiectasis. However, the causal nature of this association remains ambiguous. To clarify this potential causal linkage, we conducted a two-sample Mendelian randomization (MR) analysis to explore the bidirectional causality between RA and bronchiectasis. Methods Summary statistics for RA and bronchiectasis were obtained from the IEU OpenGWAS database We employed various methods, including inverse variance weighting (IVW), MR-Egger, weighted median, weighted mode, and simple mode, to explore potential causal links between RA and bronchiectasis. Additionally, a series of sensitivity studies, such as Cochran's Q test, MR Egger intercept test, and leave-one-out analysis, were conducted to assess the MR analysis's accuracy further. Results In the forward MR analysis, the primary analysis indicated that a genetic predisposition to RA correlated with an increased risk of bronchiectasis in European populations (IVW odds ratio (OR): 1.28, 95% confidence interval (CI): 1.20–1.37, p = 1.18E-13). Comparable results were noted in the East Asian subjects (IVW OR: 1.55, 95% CI: 1.30–1.34, p = 8.33E-07). The OR estimates from the other four methods were consistent with those obtained from the IVW method. Sensitivity analysis detected no evidence of horizontal pleiotropy or heterogeneity. Conversely, in the reverse MR analysis, we found no evidence to support a genetic causality between bronchiectasis and RA in either European or East Asian populations. Conclusion This study indicates that genetic predisposition to RA correlates with a heightened risk of bronchiectasis in both European and East Asian populations. These results imply that routine screening for bronchiectasis in RA patients could be beneficial, and effective management of RA may contribute to a reduced risk of bronchiectasis. Future research should aim to clarify the underlying mechanisms linking these two conditions.

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Prevalence and risk factors of bronchiectasis in rheumatoid arthritis: A systematic review and meta-analysis

Cited by 15 publications

References 52 publications

Systemic sclerosis and risk of bronchiectasis: A nationwide longitudinal cohort study

Systemic sclerosis and risk of bronchiectasis: A nationwide longitudinal cohort study

Diffuse lung involvement in rheumatoid arthritis: a respiratory physician's perspective

Causal relationship between rheumatoid arthritis and bronchiectasis: A bidirectional Mendelian randomization study

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