Performance of an Idiopathic Pulmonary Fibrosis-Derived Multibiomarker Panel for Rheumatoid Arthritis-Associated...

Area of Science:

• Pulmonary Medicine
• Rheumatology
• Biomarker Discovery

Background:

• Rheumatoid arthritis (RA) can be associated with interstitial lung disease (ILD), a serious complication.
• Idiopathic pulmonary fibrosis (IPF) has identified peripheral blood biomarkers.
• The utility of these IPF biomarkers in RA-ILD is not well-established.

Purpose of the Study:

• To determine if IPF-associated peripheral blood biomarkers are also associated with ILD in patients with rheumatoid arthritis (RA).
• To explore the potential for a multibiomarker panel to stratify ILD risk in RA patients.

Main Methods:

• Assessed association of eight IPF-related biomarkers in two RA cohorts (n=93, n=71).
• Generated a multibiomarker score by standardizing and summing biomarker concentrations.
• Validated the score's association with prevalent and incident ILD in a large independent cohort of US veterans with RA (n=2,507).

Main Results:

• Both development RA cohorts showed higher multibiomarker scores in RA-ILD patients compared to RA alone.
• In the validation cohort, the highest quartile of multibiomarker scores significantly increased the likelihood of prevalent ILD (aOR 2.14) and incident ILD (aHR 2.45).
• Fifteen-year cumulative hazard of incident ILD approached 20% for the highest quartile, versus <10% for others.

Conclusions:

• A multibiomarker panel derived from IPF biomarkers is associated with RA-ILD.
• This association supports shared etiopathogenesis between IPF and RA-ILD.
• Peripheral blood biomarker panels show potential for stratifying ILD risk in RA patients.