dc.contributor.author | Kiely, Patrick | |
dc.contributor.author | Busby, Amanda | |
dc.contributor.author | Nikiphorou, Elena | |
dc.contributor.author | Sullivan, Keith | |
dc.contributor.author | Walsh, David | |
dc.contributor.author | Creamer, Paul | |
dc.contributor.author | Dixey, Josh | |
dc.contributor.author | Young, Keith | |
dc.date.accessioned | 2019-08-07T00:59:52Z | |
dc.date.available | 2019-08-07T00:59:52Z | |
dc.date.issued | 2019-05-05 | |
dc.identifier.citation | Kiely , P , Busby , A , Nikiphorou , E , Sullivan , K , Walsh , D , Creamer , P , Dixey , J & Young , K 2019 , ' Is incident rheumatoid arthritis interstitial lung disease associated with methotrexate treatment? Results from a multivariate analysis in the ERAS and ERAN inception cohorts ' , BMJ Open , vol. 9 , no. 5 , e028466 . https://doi.org/10.1136/bmjopen-2018-028466 | |
dc.identifier.issn | 2044-6055 | |
dc.identifier.other | ORCID: /0000-0002-0545-0276/work/133568265 | |
dc.identifier.uri | http://hdl.handle.net/2299/21548 | |
dc.description | © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | |
dc.description.abstract | Objectives To assess predictive factors for rheumatoid arthritis interstitial lung disease (RA-ILD) in two early RA inception cohorts with a focus on methotrexate (MTX) exposure. Design Multicenter prospective early RA inception cohort studies; the early RA study (ERAS) and the early RA network (ERAN) Setting Secondary care, ERAS 9 centers, ERAN 23 centers in England, Wales and the Republic of Ireland Participants Patients with new diagnosis of RA, n=2701.Standardised data including demographics, drug therapies and clinical outcomes including the presence of RA-ILD were collected at baseline, within 3- 6 months, at 12 months and annually thereafter. Primary and secondary outcome measures Primary outcome was the association of MTX exposure on RA-ILD diagnosis. Secondary outcomes were the association of demographic, comorbid and RA specific factors on RA-ILD diagnosis and the association of MTX exposure on time to RA-ILD diagnosis. Results Of 92 eligible ILD cases, 39 occurred in 1578 (2.5%) MTX exposed and 53 in 1114 (4.8%) non-MTX exposed cases. The primary analysis of RA-ILD cases only developing after any csDMARD treatment (n=67) showed MTX exposure not to be associated with incident RA-ILD (O.R. 0.85 CI 0.49, 1.49 p=0.578) and a non-significant trend for delayed ILD diagnosis (O.R. 0.54 CI 0.28, 1.06 p=0.072). In an extended analysis including RA-ILD cases present at RA diagnosis (n=92), MTX exposure was associated with a significantly reduced risk of incident RA-ILD (O.R. 0.48, CI 0.3, 0.79 p=0.004) and longer time to ILD diagnosis (O.R. 0.41, CI 0.23, 0.75 p=0.004). Other independent baseline associations with incident RA-ILD were higher age of RA onset, ever smoking, male gender, rheumatoid nodules and longer time from first RA symptom to first out-patient visit. Conclusions MTX treatment was not associated with an increased risk of RA-ILD diagnosis. On the contrary evidence suggested that MTX may delay the onset of ILD. | en |
dc.format.extent | 3313782 | |
dc.format.extent | 3293603 | |
dc.format.extent | 1493444 | |
dc.language.iso | eng | |
dc.relation.ispartof | BMJ Open | |
dc.subject | interstitial lung disease | |
dc.subject | methotrexate | |
dc.subject | rheumatoid arthritis | |
dc.subject | Medicine(all) | |
dc.title | Is incident rheumatoid arthritis interstitial lung disease associated with methotrexate treatment? Results from a multivariate analysis in the ERAS and ERAN inception cohorts | en |
dc.contributor.institution | School of Life and Medical Sciences | |
dc.contributor.institution | Health Research Methods Unit | |
dc.contributor.institution | Centre for Health Services and Clinical Research | |
dc.contributor.institution | Department of Psychology and Sports Sciences | |
dc.contributor.institution | Department of Clinical, Pharmaceutical and Biological Science | |
dc.contributor.institution | Basic and Clinical Science Unit | |
dc.contributor.institution | Department of Clinical and Pharmaceutical Sciences | |
dc.description.status | Peer reviewed | |
dc.identifier.url | http://www.scopus.com/inward/record.url?scp=85065424337&partnerID=8YFLogxK | |
rioxxterms.versionofrecord | 10.1136/bmjopen-2018-028466 | |
rioxxterms.type | Journal Article/Review | |
herts.preservation.rarelyaccessed | true | |