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Bronchiectasis is as crucial as interstitial lung disease in the severe pneumonia that occurs during treatment with biologic DMARDs in rheumatoid arthritis: a retrospective cohort study in a single facility

  • Observational Research
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Abstract

Interstitial lung disease (ILD) carries a risk for severe pneumonia in patients with rheumatoid arthritis (RA). Bronchiectasis, another risk of severe pneumonia, has not been well elucidated in RA. We investigated the types of respiratory diseases in RA and correlated them to severe pneumonia during the course of treatment using biologic DMARDs (bDMARDs), with special attention to bronchiectasis and ILD. RA patients were examined by computed tomography before starting bDMARDs and divided into three groups: normal, bronchiectasis and ILD. The log-rank test and Dunnett’s multiple comparisons test were employed for the statistical analysis. Among 424 patients, 350 were categorized as normal, 32 as having bronchiectasis, and 42 as having ILD. Two in the normal group, three in the bronchiectasis group and four in the ILD group developed severe pneumonia. The log-rank test showed a significant difference among the three groups (p < 0.0001). The pneumonia-free rates in the bronchiectasis and ILD groups were significantly lower than the normal group, respectively, with Dunnett’s multiple comparison test (p < 0.0001). This study suggests that the bronchiectasis that occurs in RA carries a risk of severe pneumonia during treatment with bDMARDs that is comparable to ILD.

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Data availability

The datasets during analyzed this study available from the corresponding author on reasonable request.

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Not applicable.

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Authors and Affiliations

  1. Division of Rheumatology and Clinical Immunology, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan

    Kyoko Honne, Masahiro Iwamoto & Seiji Minota

  2. Division of Pulmonary Medicine, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan

    Masashi Bando

  3. Center for Information, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan

    Makiko Naka Mieno

Authors
  1. Kyoko Honne
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  2. Masashi Bando
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  3. Makiko Naka Mieno
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  4. Masahiro Iwamoto
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  5. Seiji Minota
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Contributions

Conceptualization: KH and MI; methodology: KH, MB, and MI; formal analysis: KH, MI, and MNM; investigation: KH; data curation: KH and MB; writing-original draft: KH; writing-review and editing: KH, MI, and SM; supervision: SM. All authors critically revised the report, commented on the drafts, and approved the final manuscript.

Corresponding author

Correspondence to Kyoko Honne.

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Conflict of interest

None, KH: none, MB: none, MNM, MI, and SM received royalty from Chugai Pharmaceutical Co., Ltd.

Ethical approval

Approval date: June 25, 2013; Approval #:A13-44 by the Jichi Medical University Ethical Committee.

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Declared on the website of division of Rheumatology and Clinical Immunology based on the ethical approval.

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Honne, K., Bando, M., Mieno, M.N. et al. Bronchiectasis is as crucial as interstitial lung disease in the severe pneumonia that occurs during treatment with biologic DMARDs in rheumatoid arthritis: a retrospective cohort study in a single facility. Rheumatol Int 42, 1341–1346 (2022). https://doi.org/10.1007/s00296-021-04934-z

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