Assessment of interstitial lung disease among black rheumatoid arthritis patients
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.
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.
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/m2). 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%.
• 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.
KeywordsAssociated autoimmune disease Asthma Chronic obstructive pulmonary disease Erosive disease Extra-articular manifestations Multidisciplinary meetings Non-specific interstitial pneumonia Pulmonary function test Rheumatoid arthritis Rheumatoid arthritis–related interstitial lung disease Seropositive rheumatoid arthritis Therapeutic patterns Usual interstitial pneumonia
We are grateful to Chao Ma, Sharlene Mills, Denton Smith, Stuart Clenman, and Andrea Rose-Holder for their help with data retrieval and organization.
I.M.M. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Conceptualization: I.M.M., D.J.O.; Methodology: I.M.M., S.Y.Z.L., D.J.O.; Validation: I.M.M., S.Y.Z., M.S.B., E.W., C.S.S.; Formal analysis: I.M.M., M.S.B., C.S.S., M.R.A.; Investigation: I.M.M., S.Y.Z., M.S.B., M.R.A., K.K., N.T., I.K., S.K., S.A.W., A.B., J.P., N.K., E.W., M.F., V.V., J.G., K.M., F.A.-M., H.L., R.A.S., F.S., F.M.R., V.D., M.T., C.G., C.G., K.A., L.F., M.D. T.Z.; Data curation: I.M.M., S.Y.Z.L., M.S.B. E,W.; Writing—original draft: I.M.M., M.R.A., A.B.; Writing—review and editing: I.M.M., M.S.B., S.Y.Z., M.R.A., S.F., J.M.,A.F., A.B., S.A.W., D.J.O.; Visualization: S.A.W., M.S.B., J.M., M.R.A. I.M.M.; Project administration, S.Y.Z.L., I.M.M., M.S.B.
This work is supported in part by Dr. Moro O. Salifu’s efforts through NIH Grant # S21MD012474.
Compliance with ethical standards
Prior to the initiation of the study, the protocol was reviewed and approved by the SUNY Downstate Institutional Review Board Study  and the Office of Research Administration for implementation at NYC Health + Hospitals/Kings County .
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