期刊
SEMINARS IN ARTHRITIS AND RHEUMATISM
卷 51, 期 5, 页码 1067-1080出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.semarthrit.2021.08.005
关键词
Rheumatoid arthritis; Bronchiectasis; Pulmonary
类别
资金
- National Institutes of Health (NIH) National Institute of Arthritis and Musculoskeletal and Skin Diseases [K23 AR069688, R03 AR075886, L30 AR066953, P30 AR070253, P30 AR072577]
- Rheumatology Research Founda-tion (R Bridge Award)
- R. Bruce and Joan M. Mickey Research Scholar Fund
- NIH/National Heart, Lung, and Blood Institute [K23 HL119558, R03 HL148484]
The prevalence of bronchiectasis in patients with rheumatoid arthritis is approximately 20%, with risk factors including older age, longer disease duration, genetics, and undetectable circulating mannose binding lectin (MBL).
Objectives: We performed a systematic review and meta-analysis for the prevalence and risk factors of rheu-matoid arthritis-related bronchiectasis (RA-BR). Methods: We queried PubMed and EMBASE databases to identify published literature related to prevalence and risk factors for RA-BR among patients with RA. Data extraction included study design, country, year, method of RA-BR detection, RA characteristics, numerator of RA-BR cases and denominator of patients with RA, and associations with RA-BR presence. We performed a meta-analysis using random or fixed effects mod -els to estimate the prevalence of RA-BR among RA. Results: Out of a total of 253 studies, we identified 41 total studies that reported on prevalence (n = 34), risk factors (n = 5), or both (n = 2). The included studies had heterogeneous methods to identify RA-BR. Among the 36 studies reporting prevalence, 608 RA-BR cases were identified from a total of 8569 patients with RA. In the meta-analysis, the pooled overall prevalence of RA-BR among RA was 18.7% (95%CI 13.7-24.3%) using random effects and 3.8% (95%CI 3.3-4.2%) using fixed effects. Among studies that used high-resolution chest computed tomography (HRCT) imaging, the prevalence of RA-BR was 22.6% (95%CI 16.8-29.0%) using ran-dom effects. When only considering retrospective studies (n = 12), the pooled prevalence of RA-BR among RA was 15.5% (95%CI 7.5-25.5%); among prospective studies (n = 24), the pooled prevalence was 20.7% (95% CI 14.7-27.4%). Risk factors for RA-BR included older age, longer RA duration, genetics (CFTR and HLA), and undetectable circulating mannose binding lectin (MBL) as a biomarker. Conclusion: In this systematic review and meta-analysis, the prevalence of RA-BR was nearly 20% among studies with HRCT imaging, suggesting that bronchiectasis may be a common extra-articular feature of RA. Relatively few factors have been associated with RA-BR. Future studies should standardize methods to iden-tify RA-BR cases and investigate the natural history and clinical course given the relatively high prevalence among RA. (c) 2021 Elsevier Inc. All rights reserved.
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