{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T17:21:38Z","timestamp":1791652898121,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,8,4]],"date-time":"2019-08-04T00:00:00Z","timestamp":1564876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 AR069688"],"award-info":[{"award-number":["K23 AR069688"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 HL119558"],"award-info":[{"award-number":["K23 HL119558"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["L30 AR066953"],"award-info":[{"award-number":["L30 AR066953"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 AR070253"],"award-info":[{"award-number":["P30 AR070253"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 AR072577"],"award-info":[{"award-number":["P30 AR072577"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 AR049880"],"award-info":[{"award-number":["R01 AR049880"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2019,9]]},"abstract":"Objective<\/jats:title>To evaluate rheumatoid arthritis (RA<\/jats:styled-content>) disease activity and risk of RA<\/jats:styled-content>\u2010associated interstitial lung disease (RA\u2010ILD).<\/jats:p><\/jats:sec>Methods<\/jats:title>We investigated disease activity and risk of RA\u2010ILD using the Brigham RA<\/jats:styled-content> Sequential Study (BRASS<\/jats:styled-content>, 2003\u20132016). All patients were diagnosed as having RA<\/jats:styled-content> according to accepted criteria. Disease Activity Scores in 28 joints (DAS<\/jats:styled-content>28) and covariate data were measured prospectively at annual study visits. Diagnosis of RA\u2010ILD was determined by review of images from clinically indicated chest computed tomography scans. We analyzed patients without RA\u2010ILD at baseline. We used Cox regression to estimate hazard ratios (HR<\/jats:styled-content>s) and 95% confidence intervals (CI<\/jats:styled-content>s) for RA\u2010ILD, using annually updated DAS<\/jats:styled-content>28 data, with adjustment for known RA\u2010ILD risk factors (age, sex, smoking status, RA<\/jats:styled-content> duration, and serologic status). We performed alternative analyses that did not censor at the time of missing DAS<\/jats:styled-content>28 data and included adjustment for use of methotrexate, use of glucocorticoids, presence of bone erosions, and presence of rheumatoid nodules.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 1,419 participants, the mean \u00b1 SD<\/jats:styled-content> age was 55.8 \u00b1 14.2 years, and 68.6% were seropositive for either cyclic citrullinated peptide or rheumatoid factor. We identified 85 incident cases of RA\u2010ILD during a mean \u00b1 SD<\/jats:styled-content> follow\u2010up duration of 8.9 \u00b1 4.2 years per patient. The moderate\/high disease activity group had a multivariable HR<\/jats:styled-content> of 2.22 (95% CI<\/jats:styled-content> 1.28\u20133.82) for RA\u2010ILD compared to the remission\/low disease activity group. Risk of RA\u2010ILD increased across disease activity categories: multivariable HR<\/jats:styled-content> 1.00 (reference) for remission, 1.41 (95% CI<\/jats:styled-content> 0.61\u20133.28) for low disease activity, 2.08 (95% CI<\/jats:styled-content> 1.06\u20134.05) for moderate disease activity, and 3.48 (95% CI<\/jats:styled-content> 1.64\u20137.38) for high disease activity (P<\/jats:italic> for trend = 0.001). For each unit increase in the DAS<\/jats:styled-content>28, the risk of RA\u2010ILD increased by 35% (95% CI<\/jats:styled-content> 14\u201360%). Results were similar in analyses that included follow\u2010up for missing DAS<\/jats:styled-content>28 data and with adjustment for use of methotrexate, use of glucocorticoids, presence of bone erosions, or presence of rheumatoid nodules.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Active articular RA<\/jats:styled-content> was associated with an increased risk of developing RA\u2010ILD. These results suggest that decreasing systemic inflammation may alter the natural history of RA\u2010ILD development.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40904","type":"journal-article","created":{"date-parts":[[2019,4,6]],"date-time":"2019-04-06T05:21:03Z","timestamp":1554528063000},"page":"1472-1482","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":225,"title":["Rheumatoid Arthritis Disease Activity Predicting Incident Clinically Apparent Rheumatoid Arthritis\u2013Associated Interstitial Lung Disease: A Prospective Cohort Study"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-4618","authenticated-orcid":false,"given":"Jeffrey A.","family":"Sparks","sequence":"first","affiliation":[{"name":"Brigham and Women\u2019s Hospital and Harvard Medical School Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xintong","family":"He","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Huang","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine A.","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Zaccardelli","sequence":"additional","affiliation":[{"name":"Brigham and Women\u2019s Hospital Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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