Impact of systemic inflammation and disease activity on the incidence of interstitial lung disease in patients with rheumatoid arthritis – a nested case-control study within the German biologics register RABBIT
Authors' conclusion
Higher levels of systemic inflammation, as indicated by ESR and CRP, but not joint counts or patient's global assessment, were significantly associated with the occurrence of incident ILD in patients with RA.
Study context
- Population
- Rheumatoid arthritis (RA) patients observed in the German biologics register RABBIT, 2001–2021
- Participants
- 139 vs 686
- Comparison
- Incident RA-ILD cases vs matched RA controls without interstitial lung disease (ILD)
- Casesn = 139
- Controlsn = 686reference
- Outcome
- Association of RA disease activity and its components (especially C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)) with incident ILD
Methodological detailsmatched 1:5 on sex, age, RA duration, date of enrolment and observation time, conditional logistic regression, adjusted per directed acyclic graph
- Matched 1:5 on sex, age, RA duration, date of enrolment and observation time
- Conditional logistic regression
- Adjusted per directed acyclic graph
Main finding
As reported in the abstract
Incident RA-ILD by disease activity/inflammation measure
Odds ratio (95% CI)
Averaged DAS28 (ESR)not associated
1.16(0.97–1.40)
Averaged DAS28 (CRP)not associated
1.06(0.86–1.29)
Log ESRsignificantly associated with increased risk
1.86(1.35–2.57)
Log CRPsignificantly associated with increased risk
1.55(1.21–1.97)
Observational data: associations, not effects.
Further findings
Sensitivity analyses (validated ILD cases, n=94; follow-up >12 months, n=98)
- Sensitivity analyses confirmed these findings
Original publication
Impact of systemic inflammation and disease activity on the incidence of interstitial lung disease in patients with rheumatoid arthritis – a nested case-control study within the German biologics register RABBIT. Arthritis Res Ther. Published 5 December 2024. doi:10.
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