Plasma Matrix Metalloproteinase Concentrations and Risk of Interstitial Lung Disease in a Prospective Rheumatoid Arthritis Cohort

Luedders, BA; Wheeler, AM; Ascherman, DP; Baker, JF; Duryee, MJ; Yang, Y; Roul, P; Wysham, KD; Monach, P; Reimold, A; Kerr, GS; Kunkel, G; Cannon, GW; Poole, JA; Thiele, GM; Mikuls, TR; England, BR

doi:10.1002/art.42812

Rheumatoid arthritis

Plasma Matrix Metalloproteinase Concentrations and Risk of Interstitial Lung Disease in a Prospective Rheumatoid Arthritis Cohort

Arthritis RheumatolPublished 15 Feb 2024Prospective cohort study with cross-sectional analysis

Main finding · Prevalent ILD (MMP-7, highest quartile)ResultAdjusted odds ratio 3.78 95% CI 1.86–7.65

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Authors' conclusion

MMP-7 and MMP-9 were strongly associated with both prevalent and incident ILD in this large, multicenter RA cohort after adjustment for other RA-ILD risk factors.

Study context

Population: US veterans with rheumatoid arthritis (RA) in a multicentre prospective cohort (88.9% male; mean age 63.8 years)
Participants: 2,312 veterans17,378 person-years

Exposure: Highest vs lower quartiles of plasma MMP concentrations
Outcome: Prevalent and incident ILD

Methodological detailsmulticentre, logistic and Cox regression adjusted for RA-ILD risk factors, matrix metalloproteinases (MMPs) categorized into quartiles

Multicentre
Logistic and Cox regression adjusted for RA-ILD risk factors
MMPs categorized into quartiles

Main finding

Prevalent ILD (MMP-7, highest quartile)

Adjusted odds ratio

3.78

95% CI 1.86–7.65

Highestvs lower quartiles of plasma MMP concentrations

aOR 3.78 (95% CI 1.86–7.65)

As reported in the abstract

Prevalent interstitial lung disease (ILD): 96

Observational data: associations, not effects.

Further findings

Incident ILD (MMP-7, highest quartile)

	← Lower risk ←→ Higher risk →	aHR (95% CI)
Highest MMP-7 quartile	0.20.5125	2.33 (1.35–4.02)
	0.20.5125Adjusted hazard ratio (log scale)

Incident ILD (MMP-7, highest quartile) — Incident ILD cases: 130
Incident ILD (MMP-7, highest quartile) — Crude incidence rate (/1,000 person-years): 7.5

MMP-9 and ILD

MMP-9 correlation with FVC in prevalent ILD (r): −0.30, P = 0.005
Higher MMP-9 associated with prevalent and incident ILD

Original publication

Plasma Matrix Metalloproteinase Concentrations and Risk of Interstitial Lung Disease in a Prospective Rheumatoid Arthritis Cohort. Arthritis Rheumatol. Published 15 February 2024. doi:10.1002/art.42812

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