Meta-analysis of Risk Factors for Rheumatoid Arthritis associated Interstitial Lung Disease / 中华风湿病学杂志

ABSTRACT

Objective:To evaluate the risk factors of rheumatoid arthritis associated interstitial lung disease (RA-ILD).Methods:Databases including PubMed, Sinomed, Embase, Wiley Online library were searched to collect studies on risk factors of RA-ILD. The deadline of the search was January 1 2021. Newcastle-Ottawa Scale (NOS) was used to assess the literature quality, data was extracted and analyzed by Statistical software in eligible studies.Results:This meta-analysis included 36 studies involving 3 280 patients with RA-ILD and 25 510 RA controls patients. The Incidence of RA-ILD was 6.25%. The risk of RA-ILD was 2.51 times greater in men than in women [ OR(95% CI)=2.51(2.25, 2.80)]. The mean onset age of patients with RA-ILD was 7.47 years [56.50 vs 49.04, 95% CI(6.56, 8.38)] older than those of patients with RA-nILD. The mean duration of patients with RA-ILD was 1.11 years longer than that of patients with RA-nILD [7.73 vs 6.62, 95% CI(0.68, 1.55)]. The risk of RA-ILD was two times greater in smoker than in non-smoker [ OR(95% CI)=2.25(2.01, 2.52]). Moderate evidence indicated that higher erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), disease activity score in 28 joints (DAS28)-ESR were risk factors for RA-ILD[Stan-dard Mean Difference ( SMD)(95% CI)=0.25(0.18, 0.31); SMD(95% CI)=0.25(0.18, 0.32); SMD(95% CI)=0.36(0.27, 0.45), respectively). The pooled [ OR(95% CI)=1.71(1.45, 2.01)] in rheumatoid factor (RF) positive and [ OR(95% CI)=2.41(1.80, 3.23)] anti-CCP antibody positive for the risk of RA-ILD. Conclusion:Male, smoking, older age of disease onset, long disease duration, elevated erythrocyte sedimentation rate, high C-reactive protein level, high DAS28-ESR, positive RF and anti-cyclic peptide containing citrulline antibody were risk factors for RA-ILD.