TY - JOUR
T1 - Association of Sinusitis and Upper Respiratory Tract Diseases With Incident Rheumatoid Arthritis
T2 - A Case-control Study
AU - Kronzer, Vanessa L.
AU - Huang, Weixing
AU - Zaccardelli, Alessandra
AU - Crowson, Cynthia S.
AU - Davis, John M.
AU - Vassallo, Robert
AU - Doyle, Tracy J.
AU - Losina, Elena
AU - Sparks, Jeffrey A.
N1 - Publisher Copyright:
© 2022 The Journal of Rheumatology
PY - 2022/4/1
Y1 - 2022/4/1
N2 - Objective. We aimed to determine whether specific respiratory tract diseases are associated with increased rheumatoid arthritis (RA) risk. Methods. This case-control study within the Mass General Brigham Biobank matched newly diagnosed RA cases to 3 controls on age, sex, and electronic health record history. We identified RA using a validated algorithm and confirmed by medical record review. Respiratory tract disease exposure required 1 inpatient or 2 outpatient codes at least 2 years before the index date of RA clinical diagnosis or matched date. Logistic regression models calculated ORs for RA with 95% CIs, adjusting for confounders. We then stratified by serostatus (“seropositive” was positive rheumatoid factor and/or anticitrullinated protein antibodies) and smoking. Results. We identified 741 RA cases and 2223 controls (both median age 55, 76% female). Acute sinusitis (OR 1.61, 95% CI 1.05-2.45), chronic sinusitis (OR 2.16, 95% CI 1.39-3.35), and asthma (OR 1.39, 95% CI 1.03-1.87) were associated with increased risk of RA. Acute respiratory tract disease burden during the preindex exposure period was also associated with increased RA risk (OR 1.30 per 10 codes, 95% CI 1.08-1.55). Acute pharyngitis was associated with seronegative (OR 1.68, 95% CI 1.02-2.74) but not seropositive RA; chronic rhinitis/pharyngitis was associated with seropositive (OR 2.46, 95% CI 1.01-5.99) but not seronegative RA. Respiratory tract diseases tended towards higher associations in smokers, especially > 10 pack-years (OR 1.52, 95% CI 1.02-2.27, P = 0.10 for interaction). Conclusion. Acute and chronic sinusitis, pharyngitis, and acute respiratory burden increased RA risk. The mucosal paradigm of RA pathogenesis may involve the upper respiratory tract.
AB - Objective. We aimed to determine whether specific respiratory tract diseases are associated with increased rheumatoid arthritis (RA) risk. Methods. This case-control study within the Mass General Brigham Biobank matched newly diagnosed RA cases to 3 controls on age, sex, and electronic health record history. We identified RA using a validated algorithm and confirmed by medical record review. Respiratory tract disease exposure required 1 inpatient or 2 outpatient codes at least 2 years before the index date of RA clinical diagnosis or matched date. Logistic regression models calculated ORs for RA with 95% CIs, adjusting for confounders. We then stratified by serostatus (“seropositive” was positive rheumatoid factor and/or anticitrullinated protein antibodies) and smoking. Results. We identified 741 RA cases and 2223 controls (both median age 55, 76% female). Acute sinusitis (OR 1.61, 95% CI 1.05-2.45), chronic sinusitis (OR 2.16, 95% CI 1.39-3.35), and asthma (OR 1.39, 95% CI 1.03-1.87) were associated with increased risk of RA. Acute respiratory tract disease burden during the preindex exposure period was also associated with increased RA risk (OR 1.30 per 10 codes, 95% CI 1.08-1.55). Acute pharyngitis was associated with seronegative (OR 1.68, 95% CI 1.02-2.74) but not seropositive RA; chronic rhinitis/pharyngitis was associated with seropositive (OR 2.46, 95% CI 1.01-5.99) but not seronegative RA. Respiratory tract diseases tended towards higher associations in smokers, especially > 10 pack-years (OR 1.52, 95% CI 1.02-2.27, P = 0.10 for interaction). Conclusion. Acute and chronic sinusitis, pharyngitis, and acute respiratory burden increased RA risk. The mucosal paradigm of RA pathogenesis may involve the upper respiratory tract.
KW - epidemiology
KW - pharyngitis
KW - rheumatoid arthritis
KW - sinusitis
KW - smoking
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U2 - 10.3899/jrheum.210580
DO - 10.3899/jrheum.210580
M3 - Article
C2 - 34654732
AN - SCOPUS:85122820782
SN - 0315-162X
VL - 49
SP - 358
EP - 364
JO - Journal of Rheumatology
JF - Journal of Rheumatology
IS - 4
ER -