Assessment of interstitial lung disease among black rheumatoid arthritis patients

Background Conflicting reports exist regarding the racial and the gender distribution of rheumatoid arthritis–related interstitial lung disease (RA-ILD). In a major population study of predominately Whites, RA-ILD was reported mainly among smoker middle-aged men. However, recent data suggest that th...

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Published in:	Clinical rheumatology Vol. 38; no. 12; pp. 3413 - 3424
Main Authors:	McFarlane, Isabel M., Zhaz, Su Yien, Bhamra, Manjeet S., Burza, Aaliya, Kolla, Srinivas, Alvarez, Milena Rodriguez, Koci, Kristaq, Taklalsingh, Nicholas, Pathiparampil, Joshy, Freeman, Latoya, Kaplan, Ian, Kabani, Naureen, Ozeri, David J., Watler, Elsie, Frefer, Mosab, Vaitkus, Vytas, Matthew, Keron, Arroyo-Mercado, Fray, Lyo, Helen, Zrodlowski, Tomasz, Feoktistov, Aleksander, Sanchez, Randolph, Sorrento, Cristina, Soliman, Faisal, Valdez, Felix Reyes, Dronamraju, Veena, Trevisonno, Michael, Grant, Christon, Clerger, Guerrier, Amin, Khabbab, Dawkins, Makeda, Green, Jason, Moon, Jane, Fahmy, Samir, Waite, Stephen Anthony
Format:	Journal Article
Language:	English
Published:	London Springer London 01-12-2019 Springer Nature B.V
Subjects:	African Americans - statistics & numerical data Aged Allergic diseases Arthritis, Rheumatoid - complications Asthma Black lung Cardiovascular diseases Cardiovascular Diseases - complications Chronic obstructive pulmonary disease Comorbidity Cough Cross-Sectional Studies Diagnosis Dyspnea Female Gastroesophageal reflux Gastroesophageal Reflux - complications Gender Geriatrics Health risk assessment Humans Lung diseases Lung Diseases, Interstitial - epidemiology Lung Diseases, Interstitial - etiology Male Medicine Medicine & Public Health Middle Aged New York - epidemiology Original Article Population studies Prevalence Respiration Respiratory tract diseases Retrospective Studies Rheumatoid arthritis Rheumatology Risk Factors Sex differences Smoking New York Seropositive rheumatoid arthritis Associated autoimmune disease Rheumatoid arthritis–related interstitial lung disease Usual interstitial pneumonia Therapeutic patterns Multidisciplinary meetings Asthma Non-specific interstitial pneumonia Erosive disease Pulmonary function test Extra-articular manifestations Rheumatoid arthritis Chronic obstructive pulmonary disease
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Summary:	Background Conflicting reports exist regarding the racial and the gender distribution of rheumatoid arthritis–related interstitial lung disease (RA-ILD). In a major population study of predominately Whites, RA-ILD was reported mainly among smoker middle-aged men. However, recent data suggest that the disease is that of elderly women. Our study aimed to assess the prevalence and identify the gender differences and clinical characteristics of RA-ILD in a predominantly Black population. Methods Cross-sectional analysis of data obtained from the records of 1142 patients with RA diagnosis by ICD codes of which 503 cases met the inclusion criteria for the study. Eighty-six patients had chronic respiratory symptoms of cough and dyspnea and were further assessed by our multidisciplinary group of investigators. Thirty-two subjects with an established diagnosis of rheumatoid arthritis met the diagnostic criteria for interstitial lung disease. Results Of the 32 patients with RA-ILD, mean age was 62.6 ± 2.2 (± SEM), 93.7% were females, and 89% Blacks with a BMI = 29.2 (Kg/m 2 ). Usual interstitial pneumonia (UIP) was found in 24/32 (75%) of the cases. Seventy-two percent of the RA-ILD patient had seropositive RA. Smoking history was reported in 31.3% of the cohort, gastroesophageal reflux disease (GERD) in 32.3%, and cardiovascular disease (CVD) risk factors in 65.6%. Conclusion Our study indicates RA-ILD among Blacks is predominantly a disease of elderly females with higher rates of GERD and CVD risk factors. Further studies are needed to identify the pathogenetic differences accounting for the gender distribution of RA-ILD among Black and White populations. Key Points • First study to assess ILD among predominantly Black RA patients. • The prevalence of RA-associated ILD was 6.36%, affecting mostly women in their sixth decade with seropositive disease. • COPD was the most common airway disease among non-RA-ILD Black population. • GERD was found in approximately one-third of patients with RA-associated ILD versus one-fifth of those RA patients without any lung disease.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0770-3198 1434-9949
DOI:	10.1007/s10067-019-04760-6