Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard Sect. 4, Taichung 40705, Taiwan.
Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan; School of Medicine, China Medical University, Taichung 40447, Taiwan; Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
Semin Arthritis Rheum. 2020 Oct;50(5):840-845. doi: 10.1016/j.semarthrit.2020.07.011. Epub 2020 Jul 24.
To assess interstitial lung disease (ILD) risk among patients newly diagnosed with systemic autoimmune rheumatic diseases (SARDs) including rheumatoid arthritis (RA), dermatomyositis (DMtis), polymyositis (PM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS).
Using the 1997-2013 Taiwanese National Health Insurance Research Database, we identified 62,930 newly diagnosed SARD patients from 2001 to 2013. We selected 251,720 individuals without SARD diagnoses who were matched (1:4) with SARD patients by age, sex and year of index date. We compared the incidence rates (IRs) of ILD (consistent diagnosis with ICD-9 code 515, 516.3, 516.8, 516.9 or 517 after a ILD-related radiological or pathological procedure) between the specific SARD subgroups and the corresponding non-SARD comparison groups. Using multivariable Cox regression analyses, we estimated hazard ratios (HRs) with 95% confidence intervals (CIs) of ILD in the various SARD groups compared with comparison groups after adjusting for age, sex and Charlson comorbidity index.
The IR of ILD was greatest among patients with SSc (1,364 per 10 years), followed by DMtis (1,011 per 10 years), PM (831 per 10 years), pSS (196 per 10 years), RA (109 per 10 years) and SLE (120 per 10 years). Multivariable analyses showed that the risk of ILD was increased among patients with SSc (HR, 172.63), DMtis (HR, 119.61), PM (HR, 84.89), SLE (HR, 32.18), pSS (HR, 17.54), or RA (HR, 8.29).
This population-based, cohort study demonstrates that the risk of ILD is significantly increased in patients with newly diagnosed SARDs.
评估新诊断为系统性自身免疫性风湿病（SARD）的患者（包括类风湿关节炎[RA]、皮肌炎[DMtis]、多发性肌炎[PM]、系统性硬皮病[SSc]、系统性红斑狼疮[SLE]和原发性干燥综合征[pSS]）的间质性肺病（ILD）风险。
利用 1997-2013 年台湾全民健康保险研究数据库，我们从 2001 年至 2013 年期间确定了 62930 名新诊断为 SARD 的患者。我们选择了 251720 名无 SARD 诊断的个体，他们与 SARD 患者按年龄、性别和索引日期进行了 1:4 配对。我们比较了特定 SARD 亚组和相应非 SARD 对照组之间ILD 的发病率（IR）（在ILD 相关的影像学或病理学检查后使用 ICD-9 代码 515、516.3、516.8、516.9 或 517 进行一致诊断）。使用多变量 Cox 回归分析，我们在调整年龄、性别和 Charlson 合并症指数后，估计了各种 SARD 组与对照组相比ILD 的风险比（HR）和 95%置信区间（CI）。
ILD 的发病率在 SSc 患者中最高（每 10 年 1364 例），其次是 DMtis（每 10 年 1011 例）、PM（每 10 年 831 例）、pSS（每 10 年 196 例）、RA（每 10 年 109 例）和 SLE（每 10 年 120 例）。多变量分析显示，SSc（HR，172.63）、DMtis（HR，119.61）、PM（HR，84.89）、SLE（HR，32.18）、pSS（HR，17.54）或 RA（HR，8.29）患者ILD 的风险增加。
这项基于人群的队列研究表明，新诊断为 SARD 的患者ILD 的风险显著增加。
