Clinical course of nontuberculous mycobacterial pulmonary disease in patients with rheumatoid arthritis.

IF 2 4区 医学 Q3 RHEUMATOLOGY Advances in Rheumatology Pub Date : 2024-03-15 DOI:10.1186/s42358-024-00357-z
Nakwon Kwak, Jinyoung Moon, Joong-Yub Kim, Jun Won Park, Jae-Joon Yim
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Abstract

Objectives: The impact of rheumatoid arthritis (RA) on nontuberculous mycobacterial pulmonary disease (NTM-PD) has not been well established. In this study, we investigated the clinical course of NTM-PD in patients with RA and the impact of RA on the prognosis of NTM-PD.

Methods: We analyzed patients who developed NTM-PD after being diagnosed with RA from January 2004 to August 2023 at a tertiary referral hospital in South Korea. The patient's baseline characteristics, clinical course, and prognosis were evaluated. An optimal matching analysis was performed to measure the impact of RA on the risk of mortality.

Results: During the study period, 18 patients with RA [median age, 68 years; interquartile range (IQR) 59-73; female, 88.9%] developed NTM-PD. The median interval between RA diagnosis and subsequent NTM-PD development was 14.8 years (IQR, 8.6-19.5). At a median of 30 months (IQR, 27-105) after NTM-PD diagnosis, 10 of 18 (55.6%) patients received anti-mycobacterial treatment for NTM-PD and 5 (50.0%) patients achieved microbiological cure. When matched to patients with NTM-PD but without RA, patients with both RA and NTM-PD had a higher risk of mortality (adjusted hazard ratio, 8.14; 95% confidence interval, 2.43-27.2).

Conclusion: NTM-PD occurring after RA is associated with a higher risk of mortality than NTM-PD in the absence of RA.

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类风湿性关节炎患者非结核分枝杆菌肺病的临床过程。
目的:类风湿性关节炎(RA)对非结核分枝杆菌肺病(NTM-PD)的影响尚未明确。在这项研究中,我们调查了 RA 患者 NTM-PD 的临床过程以及 RA 对 NTM-PD 预后的影响:我们分析了 2004 年 1 月至 2023 年 8 月期间在韩国一家三级转诊医院确诊为 RA 后发展为 NTM-PD 的患者。对患者的基线特征、临床过程和预后进行了评估。研究人员进行了最佳匹配分析,以衡量 RA 对死亡风险的影响:研究期间,18 名 RA 患者[中位年龄 68 岁;四分位数间距(IQR)59-73;女性,88.9%]罹患 NTM-PD。从确诊为 RA 到随后出现 NTM-PD 的中位间隔为 14.8 年(IQR,8.6-19.5)。在NTM-PD确诊后的30个月中位数(IQR,27-105),18名患者中有10名(55.6%)接受了NTM-PD抗霉菌治疗,5名(50.0%)患者实现了微生物治愈。如果与患有NTM-PD但无RA的患者进行比对,同时患有RA和NTM-PD的患者的死亡风险更高(调整后危险比为8.14;95%置信区间为2.43-27.2):结论:与无RA的NTM-PD相比,RA后发生的NTM-PD与更高的死亡风险相关。
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来源期刊
Advances in Rheumatology
Advances in Rheumatology Medicine-Rheumatology
CiteScore
4.00
自引率
4.30%
发文量
41
审稿时长
53 weeks
期刊介绍: Formerly named Revista Brasileira de Reumatologia, the journal is celebrating its 60th year of publication. Advances in Rheumatology is an international, open access journal publishing pre-clinical, translational and clinical studies on all aspects of paediatric and adult rheumatic diseases, including degenerative, inflammatory and autoimmune conditions. The journal is the official publication of the Brazilian Society of Rheumatology and welcomes original research (including systematic reviews and meta-analyses), literature reviews, guidelines and letters arising from published material.
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