{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:14:37Z","timestamp":1792102477893,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100020167","name":"Gordon and Llura Gund Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020167","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000980","name":"Arthritis Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000980","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30 AR070253"],"award-info":[{"award-number":["P30 AR070253"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["P30 AR072577"],"award-info":[{"award-number":["P30 AR072577"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR077607"],"award-info":[{"award-number":["R01 AR077607"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR080659"],"award-info":[{"award-number":["R01 AR080659"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01 HL155522"],"award-info":[{"award-number":["R01 HL155522"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association between rheumatoid arthritis\u2013associated lung disease (RA\u2010LD) and serious infection risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using the Massachusetts General Brigham Biobank (Boston, MA, USA), comparing RA\u2010LD with patients with RA without lung disease (RA\u2010no LD), matched by age, sex, and RA duration. Cases of RA\u2010LD were verified by medical record review and chest imaging for clinically apparent RA\u2010associated interstitial lung disease (RA\u2010ILD) and\/or RA\u2010associated bronchiectasis (RA\u2010BR). The primary outcome was serious infection. Incidence rates and propensity score\u2013adjusted subdistribution hazard ratios (sdHRs) were calculated using Fine and Gray models to account for competing risk of death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 221 patients with RA\u2010LD (151 RA\u2010ILD and 70 RA\u2010BR) and 980 RA\u2010no LD comparators, RA\u2010LD had a significantly higher serious infection risk compared with RA\u2010no LD comparators (55.8 vs 25.8 per 1,000 person\u2010years; sdHR 1.60; 95% confidence interval [CI] 1.20\u20132.12). The increased risk remained significant for those with RA\u2010ILD (sdHR 1.79; 95% CI 1.33\u20132.41) but not for RA\u2010BR (sdHR 1.19; 95% CI 0.72\u20131.97). Anatomic sites of infection that were more common in RA\u2010LD included pulmonary, skin and soft tissue, and ear, nose, and throat; RA\u2010LD was associated with various pathogen types, including virus, bacteria, fungus, and mycobacteria. Specific pathogens with higher frequency in cases of RA\u2010LD, particularly among RA\u2010BR, included influenza virus, respiratory syncytial virus,\n                      <jats:italic>Staphylococcus<\/jats:italic>\n                      ,\n                      <jats:italic>Pseudomonas<\/jats:italic>\n                      , and nontuberculous mycobacteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RA\u2010LD, particularly RA\u2010ILD, is associated with a significant increased risk of serious infection across anatomic sites and diverse pathogen types. RA\u2010BR is associated with increased pulmonary infections. Prospective studies and trials are needed to clarify optimal approaches to treat patients with RA\u2010LD and reduce infection risk.<\/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\/art43338-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\/art.43338","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T07:28:44Z","timestamp":1753428524000},"page":"37-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Risk of Serious Infection in Patients With Rheumatoid Arthritis\u2013Associated Interstitial Lung Disease or Bronchiectasis: A Comparative Cohort Study"],"prefix":"10.1002","volume":"78","author":[{"given":"Qianru","family":"Zhang","sequence":"first","affiliation":[{"name":"Brigham and Women's Hospital and Harvard Medical School Boston, Massachusetts, and Department of Rheumatology and Immunology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-214X","authenticated-orcid":false,"given":"Ying","family":"Qi","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosong","family":"Wang","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital  Boston 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