{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:02:10Z","timestamp":1792735330720,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007949","name":"Reumatikerf\u00f6rbundet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004885","name":"Ume\u00e5 Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004885","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2018\u201002551"],"award-info":[{"award-number":["2018\u201002551"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Pulmonary fibrosis (PF) is a severe extra\u2010articular manifestation of rheumatoid arthritis (RA). This study aimed to externally validate a genetic risk score (GRS) and a combined risk score (CRS) for predicting the risk of RA\u2010associated PF in an independent cohort of patients with early RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used an inception cohort of 1,118 patients diagnosed with RA from northern Sweden between 1996 and 2016. Clinical data were systematically collected, and genotyping was performed for 12 single\u2010nucleotide polymorphisms (SNPs) associated with idiopathic PF. Statistical analyses, including logistic regression and area under the curve (AUC) assessments, were conducted to evaluate the performance of the GRS and in combination with clinical data as the CRS in predicting RA\u2010PF development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 1,115 patients with complete data, 60 (5.6%) were diagnosed with PF. PF was significantly associated with age, rheumatoid factor positivity, disease activity, and\n                      <jats:italic>MUC5B<\/jats:italic>\n                      (rs35705950) and\n                      <jats:italic>FAM13A<\/jats:italic>\n                      (rs2609255) SNPs. The GRS demonstrated a significant association with RA\u2010PF (odds ratio 2.6, 95% confidence interval 1.6\u20134.5), whereas the CRS exhibited superior performance (AUC 0.75,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) compared to the GRS alone (AUC 0.62). The combined risk score outperformed the GRS in discriminating RA\u2010PF, indicating its potential utility in clinical practice.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides external validation of the Veterans Affairs Rheumatoid Arthritis Registry interstitial lung disease GRS (VARA\u2010ILD\u2010GRS) and the VARA\u2010ILD\u2010CRS in an RA cohort, demonstrating their generalizability and effectiveness in identifying individuals at high risk for RA\u2010ILD. The findings support the integration of genetic and clinical data in risk stratification models, which could significantly improve screening strategies for patients with RA at risk of developing PF.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/acr25696-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr.25696","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T14:27:39Z","timestamp":1763130459000},"page":"696-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Validation of a Genetic Risk Score Combined With Clinical Variables for Predicting Pulmonary Fibrosis in Early Rheumatoid Arthritis"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7675-3488","authenticated-orcid":false,"given":"Mikael","family":"Brink","sequence":"first","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Rheumatology Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8816-7782","authenticated-orcid":false,"given":"Austin","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Division of Rheumatology &amp; Immunology, Department of Internal Medicine University of Nebraska Medical Center &amp; VA Nebraska\u2010Western Iowa Health Care System  Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-3588","authenticated-orcid":false,"given":"Bryant R.","family":"England","sequence":"additional","affiliation":[{"name":"Division of Rheumatology &amp; Immunology, Department of Internal Medicine University of Nebraska Medical Center &amp; VA Nebraska\u2010Western Iowa Health Care System  Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8259-3863","authenticated-orcid":false,"given":"Solbritt","family":"Rantap\u00e4\u00e4\u2010Dahlqvist","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Rheumatology Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2013.05.001"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40574"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keu165"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-019-00276-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25432"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae001"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801562"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab441"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae615"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780380107"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2021-221754"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201807-1255ST"},{"key":"e_1_2_6_15_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Development Core Team","year":"2022"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-12-77"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2025.152708"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202403-238OC"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21575"}],"container-title":["Arthritis Care &amp; 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