Division of Pulmonary, Critical Care, Hyperbaric, Allergy and Sleep Medicine, and.
Department of Medicine, Loma Linda University Health, Loma Linda, California.
Ann Am Thorac Soc. 2021 Dec;18(12):1970-1977. doi: 10.1513/AnnalsATS.202102-115OC.
The burden of rheumatoid arthritis (RA) and RA-associated interstitial lung disease (RA-ILD) in recent years has not been well characterized. In this study, we sought to describe RA- and RA-ILD-related mortality rates and trends in the United States from 2005 to 2018, stratified by demographics. We used the Multiple Cause of Death Database available through the Centers for Disease Control and prevention website, which contains data of all deceased U.S. residents. RA- and RA-ILD-related deaths were identified using codes. We examined the age-adjusted mortality rates and trends stratified by demographics. RA- and RA-ILD-related mortality rates were higher in women and older age groups. However, the prevalence of ILD was higher in male decedents with RA compared with female decedents with RA (13.3% vs. 8.7%). RA-related mortality rates were the highest in Native American individuals followed by White individuals. Compared with White individuals, Hispanic individuals had lower RA-related mortality rates but higher RA-ILD-related mortality rates. Overall RA-related mortality rates per 1,000,000 population members decreased from 30.6 in 2005 to 22.2 in 2018. RA-related mortality rates declined in both sexes, all races, and all age groups. However, RA-ILD-related mortality rates remained stable in both sexes, all races, and all age groups except for the group aged 65 to 84 years, in which the rates declined. The overall RA-related mortality rates are decreasing; however, RA-ILD-related mortality rates remain stable except in the group aged 65-84 years. This would suggest that therapies for RA and improvement in the management of other comorbidities have improved the overall outcomes in patients with RA but have had limited effect in the subgroup of patients with RA-ILD.
类风湿关节炎（RA）和与 RA 相关的间质性肺疾病（RA-ILD）的负担近年来一直没有得到很好的描述。在这项研究中，我们试图描述 2005 年至 2018 年美国 RA 和 RA-ILD 相关死亡率和趋势，按人口统计学分层。我们使用了疾病控制和预防中心网站上提供的多病因死亡数据库，其中包含了所有美国居民的死亡数据。使用代码确定了与 RA 和 RA-ILD 相关的死亡。我们检查了按人口统计学分层的年龄调整死亡率和趋势。女性和年龄较大的人群中 RA 和 RA-ILD 相关死亡率较高。然而，与女性 RA 死者相比，男性 RA 死者中ILD 的患病率更高（13.3%比 8.7%）。RA 相关死亡率在美洲原住民个体中最高，其次是白人个体。与白人个体相比，西班牙裔个体的 RA 相关死亡率较低，但 RA-ILD 相关死亡率较高。每 100 万人群成员中 RA 相关死亡率从 2005 年的 30.6 人下降到 2018 年的 22.2 人。男女两性、所有种族和所有年龄组的 RA 相关死亡率均下降。然而，除了 65 至 84 岁年龄组外，男女两性、所有种族和所有年龄组的 RA-ILD 相关死亡率保持稳定，在该年龄组中，死亡率下降。RA 相关死亡率总体呈下降趋势；然而，除了 65-84 岁年龄组外，RA-ILD 相关死亡率保持稳定。这表明 RA 的治疗和其他合并症管理的改善改善了 RA 患者的总体结局，但对 RA-ILD 患者亚组的影响有限。
