A potential role for chlamydial infection in rheumatoid arthritis development
Authors' conclusion
Self-reported chlamydial infections are associated with elevated RA autoimmunity in at-risk individuals.
Study context
- Population
- First-degree relatives of rheumatoid arthritis (RA) patients (RA-FDR) in a prospective Swiss-based cohort who answered a questionnaire on past chlamydial infections
- Participants
- 1,231 RA-FDRs
- Comparison
- Prior chlamydial infection in RA-FDRs with RA autoimmunity vs controls
- RA autoimmunityn = 168
- Outcome
- RA autoimmunity (positivity for ACPA and/or RF)
Methodological detailsSwiss-based RA-FDR cohort, independent USA-based replication cohort
- Swiss-based RA-FDR cohort
- Independent USA-based replication cohort
Main finding
As reported in the abstract
Prevalence of self-reported chlamydial infection
RA autoimmunity vs ControlsEstimate (95% CI)P value
Prevalence of self-reported chlamydial infection
OR 2.00(1.27–3.09)
P < 0.01Remained significant after adjustments
OR (adjusted) 1.91(1.20–2.95)
- RA-FDRs who developed RA autoimmunity
- 168 (13.6%)
Observational data: associations, not effects.
Secondary outcomes
Positive C. trachomatis serology and high levels of RA autoimmunity
| OR (95% CI) | P value | ||
|---|---|---|---|
| Positive C. trachomatis serology | 3.05 (1.10–8.46) | P = 0.032 | |
| 0.10.31310Odds ratio (log scale) |
Later stages of RA development
- Stronger effect sizes were observed in later stages of RA development
Replication cohort (USA)
- Significant associations between chlamydial infection and rheumatoid factor (RF) positivity and incident RA, but not anti-CCP positivity
Original publication
A potential role for chlamydial infection in rheumatoid arthritis development. Rheumatology (Oxford). Published 13 December 2023. doi:10.
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