RESEARCH - Incidence of and risk factors for interstitial pneumonia in patients with RA: IORRA

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Mod Rheumatol. 2010 Jun;20(3):280-6. Epub 2010 Mar 10.

Incidence of and risk factors for interstitial pneumonia in patients

with rheumatoid arthritis in a large Japanese observational cohort,

IORRA.

Shidara K, Hoshi D, Inoue E, Yamada T, Nakajima A, Taniguchi A, Hara

M, Momohara S, Kamatani N, Yamanaka H.

Institute of Rheumatology, Tokyo Women's Medical University, 10-22

Kawada-cho, Shinjyuku-ku, Tokyo 162-0054, Japan.

Abstract

Interstitial lung disease (ILD) is a frequently encountered and

sometimes life-threatening complication among patients with rheumatoid

arthritis (RA). In this study, we aim to clarify the incidence of and

risk factors for ILD using a large observational cohort of RA

patients. We analyzed the database from a large observational cohort

of Japanese RA patients, the Institute of Rheumatology, Rheumatoid

Arthritis (IORRA) cohort. We defined as interstitial pneumonia (IP)

computed tomography (CT) pattern of nonspecific interstitial pneumonia

or diffuse alveolar damage. Newly developed IP was identified from

patient reports over 2.5 years (April 2004 to October 2006) and was

confirmed by extensive medical record, chest X-ray radiograph, and CT.

The raw and age/gender-adjusted incidence of IP were reported. IP risk

factors were analyzed using a nested case-control design was employed

using conditional logistic regression analysis with a stepwise method.

Thirty-seven patients among 5,699 RA patients were diagnosed with

newly developed IP, including 18 cases with methotrexate-induced

pneumonitis (MTX-IP) and 15 cases with IP associated with RA (RA-IP).

The age-adjusted incidence of MTX-IP among total patients, males, and

females was 3.775, 6.667, and 1.013 per 1,000 cases, respectively, and

of RA-IP among total patients, males, and females was 1.056, 1.452,

and 0.677 per 1,000 cases, respectively. Conditional logistic

regression analysis after stepwise variable selection identified male

gender, increased Japanese version of the Health Assessment

Questionnaire (J-HAQ) score, decreased pain visual analog scale (VAS),

and elevated erythrocyte sedimentation rate as significant risk

factors for MTX-IP, while the only risk factor for RA-IP was male

gender. The incidence of and risk factors for IP in RA patients were

determined in a large observational cohort of RA patients in Japan.

PMID: 20217173

http://www.ncbi.nlm.nih.gov/pubmed/20217173

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