Rheumatoid arthritis, quantitative parenchymal lung features and mortality among smokers
Authors' conclusion
Using machine learning-derived QCT data in a cohort of smokers, RA was associated with higher percentage of interstitial changes. The combination of RA and emphysema conferred >5-fold higher mortality.
Study context
- Population
- Current or former smokers in COPDGene
- Participants
- 82 vs 8,820
- Exposure
- RA vs non-RA participants
- RAn = 82
- Non-RAn = 8,820reference
- Outcome
- Cross-sectional prevalence of QCT parenchymal lung features (% normal lung, interstitial changes, emphysema) and their mortality associations
Methodological detailsmachine learning-derived quantitative CT (QCT) (k-nearest neighbour quantifier), multivariable linear regression, Cox regression
- Machine learning-derived QCT (k-nearest neighbour quantifier)
- Multivariable linear regression
- Cox regression
Main finding
As reported in the abstract
QCT features, RA vs non-RA (multivariable linear regression)
Β (% interstitial changes)
1.7
P = 0.0008
[0.5]
Β (% emphysema)
1.3
P = 0.44
[1.7]
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Mortality, RA with >75th percentile of emphysemaRA with >75th percentile emphysemavs Non-RA | 5.86 (3.75–9.13) | |
| Mortality, RA with >75th percentile of emphysemaRA with >75th percentile emphysemavs RA with ≤75th percentile emphysema | 5.56 (2.71–11.38) | |
| 0.050.21520Hazard ratio (log scale) |
| Outcome | Attributable proportion (95% CI) | P value |
|---|---|---|
| Interaction between RA and emphysema for mortality | 0.53 (0.30–0.70) | multiplicative P = 0.014 |
Original publication
Rheumatoid arthritis, quantitative parenchymal lung features and mortality among smokers. Rheumatology (Oxford). Published 4 December 2023. doi:10.
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