Serum Biomarkers of Pulmonary Damage and Risk for Progression of Rheumatoid Arthritis–Associated Interstitial Lung Disease
Authors' conclusion
In this first prospective study to apply PPF criteria to RA-ILD, 34.6% progressed over 3 years. Higher baseline KL-6 and hSP-D were associated with progression. In follow-up, greater change in KL-6 was associated with progression.
Study context
- Population
- Patients with RA and ILD confirmed by chest CT in the Korean Rheumatoid Arthritis Interstitial Lung Disease (KORAIL) cohort, followed annuallymean age 66.5 yrs, 30% male
- Participants
- 136 patients
- Outcome
- ILD progression: worsening in physiological and radiological domains of the 2022 ATS/ERS/JRS/ALAT guideline for progressive pulmonary fibrosis (PPF)
Methodological detailsmultivariable Cox regression
- Multivariable Cox regression
Main finding
As reported in the abstract
ILD progression by baseline biomarker levels · median 3.0 years of follow-up
Patients with progression
47
34.6%
Higher baseline KL-6, multivariable HR
1.37 (1.03-1.82) (95% CI)
Higher baseline hSP-D, multivariable HR
1.51 (1.09-2.08) (95% CI)
Highest quartile of MMP-7 (only quartile with increased risk), multivariable HR
2.60 (1.07-6.33) (95% CI)
Observational data: associations, not effects.
Further findings
ILD progression by increasing serum KL-6 at 1 year (∆KL-6)
- ∆KL-6, multivariable HR
- 2.00 (1.29-3.11) (95% CI)
- Additionally adjusting for baseline biomarker levels
Original publication
Serum Biomarkers of Pulmonary Damage and Risk for Progression of Rheumatoid Arthritis–Associated Interstitial Lung Disease. J Rheumatol. Published 15 January 2025. doi:10.
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