Combining Three Peripheral Blood Biomarkers to Stratify Rheumatoid Arthritis-Associated Interstitial Lung Disease...

Area of Science:

• Rheumatology
• Pulmonology
• Biomarker Discovery

Background:

• Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a significant complication of rheumatoid arthritis (RA).
• Accurate risk stratification for RA-ILD is crucial for timely intervention and management.
• Current risk assessment models may not fully capture individual patient risk.

Purpose of the Study:

• To evaluate a novel biomarker score for stratifying the risk of prevalent and incident RA-ILD.
• The score comprises the MUC5B rs35705950 promoter variant, plasma matrix metalloproteinase (MMP)-7, and serum anti-malondialdehyde-acetaldehyde (anti-MAA) antibody.

Main Methods:

• A multicenter cohort study of US veterans with RA was conducted, including cross-sectional analysis of prevalent RA-ILD and cohort study of incident RA-ILD.
• A three-analyte biomarker score (0-3) was calculated based on MUC5B variant presence and elevated MMP-7 and anti-MAA antibody levels.
• Multivariate logistic and Cox regression models were used, adjusting for clinical risk factors.

Main Results:

• Among 2,043 RA participants, a higher biomarker score was associated with increased odds of prevalent RA-ILD (aOR 12.21 for score 3 vs. 0).
• A score of 3 also indicated the highest risk for incident RA-ILD (aHR 4.36).
• Combining the biomarker score with clinical factors improved risk prediction for both prevalent and incident RA-ILD.

Conclusions:

• The evaluated three-analyte biomarker score demonstrates association with both prevalent and incident RA-ILD.
• This score enhances risk stratification beyond traditional clinical factors.
• While not yet ready for clinical implementation, the findings highlight the potential of biomarker scores for RA-ILD risk assessment.