RA autoantibodies as predictors of rheumatoid arthritis in non-cystic fibrosis bronchiectasis patients

Perry, Elizabeth; Stenton, Chris; Kelly, Clive; Eggleton, Paul; Hutchinson, David; Soyza, Anthony De

doi:10.1183/09031936.00064014

Cited by 43 publications

(38 citation statements)

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“…This might explain the higher, although not significant, degree of airflow limitation and lower DLCO in ACPA-positive patients as compared with ACPA-negative patients, in accordance with our previous report in a larger cohort of patients 8. However, ACPA has been previously associated with classic smoking-related disorders such as bronchiectasis independent of smoking status in patients with24 or without RA 25 26. In line with this, heavy smoking (defined as more than 10 pack-years) was equally present in both ACPA-positive and ACPA-negative RA groups.…”

Section: Discussionsupporting

confidence: 90%

Signs of immune activation and local inflammation are present in the bronchial tissue of patients with untreated early rheumatoid arthritis

et al. 2015

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Section: Discussionsupporting

confidence: 90%

Signs of immune activation and local inflammation are present in the bronchial tissue of patients with untreated early rheumatoid arthritis

et al. 2015

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“…Presence of circulating RF in patients was shown to be more prevalent in patients with bronchiectasis compared with healthy controls in a prospective multi-centre case-control observational study. 97 However anti-CCP antibodies were strongly positive in only 12% (4 patients) of those who were RF-positive. Two of those four patients subsequently developed rheumatoid arthritis in a 12 month follow-up period.…”

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confidence: 94%

British Thoracic Society Guideline for bronchiectasis in adults

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Chalmers

et al. 2018

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“…In our previous study, we found that bronchiectasis patients with no evidence of RA had higher RF positivity compared to age-sex matched controls. A small but significant proportion of these were also anti-CCP positive and over a 12 month period developed RA 32 .…”

Section: Discussionmentioning

confidence: 99%

Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co‐existent bronchiectasis

et al. 2015

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AimPatients with rheumatoid arthritis (RA) and co‐existent bronchiectasis (BRRA) have a five‐fold increased mortality compared to rheumatoid arthritis alone. Yet previous studies have found no difference in clinical and serological markers of RA disease severity between BRRA patients and RA alone. However, RA disease activity measures such as Disease Activity Score of 28 joints – C‐reactive protein (DAS28‐CRP) and anti‐cyclic citrullinated peptide antibodies (anti‐CCP) have not been studied, so we assessed these parameters in patients with BRRA and RA alone.MethodsBRRA patients (n = 53) had high‐resolution computed tomography proven bronchiectasis without any interstitial lung disease and ≥ 2 respiratory infections/year. RA alone patients (n = 50) had no clinical or radiological evidence of lung disease. DAS28‐CRP, rheumatoid factor (immunoglobulin M) and anti‐CCP were measured in all patients, together with detailed clinical and radiology records.ResultsIn BRRA, bronchiectasis predated RA in 58% of patients. BRRA patients had higher DAS28 scores (3.51 vs. 2.59), higher levels of anti‐CCP (89% vs. 46%) and rheumatoid factor (79% vs. 52%) (P = 0.003) compared to RA alone. Where hand and foot radiology findings were recorded, 29/37 BRRA (78%) and 13/30 (43%) RA alone had evidence of erosive change (P = 0.003). There were no significant differences between groups in smoking history or disease‐modifying anti‐rheumatic drug/biologic therapy.ConclusionsIncreased levels of RA disease activity, severity and RA autoantibodies are demonstrated in patients with RA and co‐existent bronchiectasis compared to patients with RA alone, despite lower tobacco exposure. This study demonstrates that BRRA is a more severe systemic disease than RA alone.

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RA autoantibodies as predictors of rheumatoid arthritis in non-cystic fibrosis bronchiectasis patients

Cited by 43 publications

References 15 publications

Signs of immune activation and local inflammation are present in the bronchial tissue of patients with untreated early rheumatoid arthritis

Signs of immune activation and local inflammation are present in the bronchial tissue of patients with untreated early rheumatoid arthritis

British Thoracic Society Guideline for bronchiectasis in adults

Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co‐existent bronchiectasis

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