{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:18:07Z","timestamp":1785251887045,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,7,22]],"date-time":"2015-07-22T00:00:00Z","timestamp":1437523200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000341","name":"Arthritis Research UK","doi-asserted-by":"crossref","award":["19894"],"award-info":[{"award-number":["19894"]}],"id":[{"id":"10.13039\/501100000341","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000384","name":"Higher Education Funding Council for England (HEFCE)","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000384","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Cornwall Arthritis Trust"},{"name":"Northcott Devon Medical Foundation"},{"name":"Dutchy Health Charity"},{"name":"National Institute for Health Research CLRN"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Rheum Dis"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Patients with rheumatoid arthritis (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>) and co\u2010existent bronchiectasis (<jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content>) have a five\u2010fold increased mortality compared to rheumatoid arthritis alone. Yet previous studies have found no difference in clinical and serological markers of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> disease severity between <jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content> patients and <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> alone. However, <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> disease activity measures such as Disease Activity Score of 28 joints \u2013 C\u2010reactive protein (<jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>) and anti\u2010cyclic citrullinated peptide antibodies (anti\u2010<jats:styled-content style=\"fixed-case\">CCP<\/jats:styled-content>) have not been studied, so we assessed these parameters in patients with <jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content> patients (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>53) had high\u2010resolution computed tomography proven bronchiectasis without any interstitial lung disease and \u2265\u00a02 respiratory infections\/year. <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> alone patients (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>50) had no clinical or radiological evidence of lung disease. <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28\u2010<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>, rheumatoid factor (immunoglobulin M) and anti\u2010<jats:styled-content style=\"fixed-case\">CCP<\/jats:styled-content> were measured in all patients, together with detailed clinical and radiology records.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In <jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content>, bronchiectasis predated <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> in 58% of patients. <jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content> patients had higher <jats:styled-content style=\"fixed-case\">DAS<\/jats:styled-content>28 scores (3.51 <jats:italic>vs<\/jats:italic>. 2.59), higher levels of anti\u2010<jats:styled-content style=\"fixed-case\">CCP<\/jats:styled-content> (89% <jats:italic>vs<\/jats:italic>. 46%) and rheumatoid factor (79% <jats:italic>vs<\/jats:italic>. 52%) (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003) compared to <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> alone. Where hand and foot radiology findings were recorded, 29\/37 <jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content> (78%) and 13\/30 (43%) <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> alone had evidence of erosive change (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003). There were no significant differences between groups in smoking history or disease\u2010modifying anti\u2010rheumatic drug\/biologic therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Increased levels of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> disease activity, severity and <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> autoantibodies are demonstrated in patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> and co\u2010existent bronchiectasis compared to patients with <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> alone, despite lower tobacco exposure. This study demonstrates that <jats:styled-content style=\"fixed-case\">BRRA<\/jats:styled-content> is a more severe systemic disease than <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> alone.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1756-185x.12702","type":"journal-article","created":{"date-parts":[[2015,7,22]],"date-time":"2015-07-22T11:13:14Z","timestamp":1437563594000},"page":"2003-2011","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Increased disease activity, severity and autoantibody positivity in rheumatoid arthritis patients with co\u2010existent bronchiectasis"],"prefix":"10.1111","volume":"20","author":[{"given":"Elizabeth","family":"Perry","sequence":"first","affiliation":[{"name":"Department of Rheumatology Musgrove Park Hospital Taunton Somerset UK"},{"name":"University of Exeter Medical School Devon UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Eggleton","sequence":"additional","affiliation":[{"name":"University of Exeter Medical School Devon UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"De Soyza","sequence":"additional","affiliation":[{"name":"Lung Immunobiology and Transplantation Group Institute of Cellular Medicine Newcastle University Newcastle UK"},{"name":"Sir William Leech Centre Freeman Hospital Newcastle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Royal Cornwall Hospital Trust Truro UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clive","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Rheumatology Queen Elizabeth Hospital Gateshead UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,22]]},"reference":[{"issue":"142","key":"e_1_2_6_2_1","first-page":"239","article-title":"Pulmonary infections and rheumatoid arthritis","volume":"36","author":"Walker WC","year":"1967","journal-title":"Q J Med"},{"issue":"10","key":"e_1_2_6_3_1","first-page":"531","article-title":"Prevalence of symptomatic bronchiectasis in patients with rheumatoid arthritis","volume":"64","author":"Allain J","year":"1997","journal-title":"Rev Rhum"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.56.10.596"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.54.4.308"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1756-185X.2009.01376.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.193.2.7972746"},{"issue":"7","key":"e_1_2_6_8_1","first-page":"453","article-title":"Prospective study of the prevalence of bronchiectasis in rheumatoid arthritis using high\u2010resolution computed tomography","volume":"65","author":"Despaux J","year":"1998","journal-title":"Rev Rhum"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.52.11.776"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2006.02.003"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-11-304"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-011-1849-4"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/36.6.689"},{"issue":"11","key":"e_1_2_6_14_1","first-page":"801","article-title":"Rheumatoid arthritis and bronchiectasis. 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