Impact of Bronchiectasis on Long-Term Mortality in Patients with Rheumatoid Arthritis: A Real-World Retrospective Cohort Study
4 affiliations
- 1Department of Rheumatology, Clinical Research Center for Rheumatic Diseases, National Hospital Organization (NHO) Kumamoto Saishun Medical Center, Kohshi 861-1196, Kumamoto, Japan
- 2Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama 236-0051, Kanagawa, Japan
- 3Department of Respiratory Medicine, Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo 276-8524, Chiba, Japan
- 4Department of Respiratory Medicine, NHO Kumamoto Saishun Medical Center, Kohshi 861-1196, Kumamoto, Japan
Abstract
Objectives: This study aimed to examine the impact of bronchiectasis on long-term mortality in patients with rheumatoid arthritis (RA). Methods: We used real-world cohort data from patients who were diagnosed with RA at our institution between April 2001 and June 2023. Pulmonary conditions were evaluated using high-resolution computed tomography imaging taken at RA diagnosis and over the disease course. Traction bronchiectasis was not included in the diagnosis of bronchiectasis. Results: Among 766 patients with RA, 2.7% were diagnosed with bronchiectasis plus interstitial lung disease (ILD), 5.6% with bronchiectasis alone, and 7.3% with ILD alone. During follow-up with a mean of 9.7 years, the crude incidence rate of death (95% confidence interval [CI]) per 100 person-years was 11.1 (6.7–18.4) in RA patients with bronchiectasis plus ILD; 7.0 (4.6–10.5) in those with bronchiectasis alone; 6.8 (4.6–10.1) in those with ILD alone; and 1.2 (1.0–1.5) in those without either complication. The standardized mortality ratio (95% CI) compared with the general population was 2.57 (1.76–3.39) for RA patients with bronchiectasis; 2.17 (1.50–2.85) for those with ILD; and 0.93 (0.73–1.14) for those without either complication. In multivariable Cox regression analysis using RA diagnosis as the index date and treating pulmonary complications as time-varying exposure variables, the presence of bronchiectasis alone or ILD alone, advanced age, and low body mass index were identified as strong predictive factors for death. The adjusted hazard ratio (95% CI) was 2.37 (1.48–3.82) for bronchiectasis alone and 3.16 (1.92–5.22) for ILD alone. When limited to bronchiectasis patients with and without ILD, the complication of ILD did not influence the mortality risk. Conclusions: Bronchiectasis was associated with excess mortality in RA patients, regardless of the complication of ILD. Bronchiectasis and ILD had similar levels of increased mortality risk in RA patients.
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BibTeX
@article{mori2026impact,
title = {{Impact of Bronchiectasis on Long-Term Mortality in Patients with Rheumatoid Arthritis: A Real-World Retrospective Cohort Study}},
author = {Shunsuke Mori and Fumikazu Sakai and Mizue Hasegawa and Kazuyoshi Nakamura},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218703},
url = {https://www.mdpi.com/2077-0383/15/21/8703},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of Bronchiectasis on Long-Term Mortality in Patients with Rheumatoid Arthritis: A Real-World Retrospective Cohort Study
AU - Shunsuke Mori
AU - Fumikazu Sakai
AU - Mizue Hasegawa
AU - Kazuyoshi Nakamura
PY - 2026
DA - 2026/11/07
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218703
UR - https://www.mdpi.com/2077-0383/15/21/8703
AB - Objectives: This study aimed to examine the impact of bronchiectasis on long-term mortality in patients with rheumatoid arthritis (RA). Methods: We used real-world cohort data from patients who were diagnosed with RA at our institution between April 2001 and June 2023. Pulmonary conditions were evaluated using high-resolution computed tomography imaging taken at RA diagnosis and over the disease course. Traction bronchiectasis was not included in the diagnosis of bronchiectasis. Results: Among 766 patients with RA, 2.7% were diagnosed with bronchiectasis plus interstitial lung disease (ILD), 5.6% with bronchiectasis alone, and 7.3% with ILD alone. During follow-up with a mean of 9.7 years, the crude incidence rate of death (95% confidence interval [CI]) per 100 person-years was 11.1 (6.7–18.4) in RA patients with bronchiectasis plus ILD; 7.0 (4.6–10.5) in those with bronchiectasis alone; 6.8 (4.6–10.1) in those with ILD alone; and 1.2 (1.0–1.5) in those without either complication. The standardized mortality ratio (95% CI) compared with the general population was 2.57 (1.76–3.39) for RA patients with bronchiectasis; 2.17 (1.50–2.85) for those with ILD; and 0.93 (0.73–1.14) for those without either complication. In multivariable Cox regression analysis using RA diagnosis as the index date and treating pulmonary complications as time-varying exposure variables, the presence of bronchiectasis alone or ILD alone, advanced age, and low body mass index were identified as strong predictive factors for death. The adjusted hazard ratio (95% CI) was 2.37 (1.48–3.82) for bronchiectasis alone and 3.16 (1.92–5.22) for ILD alone. When limited to bronchiectasis patients with and without ILD, the complication of ILD did not influence the mortality risk. Conclusions: Bronchiectasis was associated with excess mortality in RA patients, regardless of the complication of ILD. Bronchiectasis and ILD had similar levels of increased mortality risk in RA patients.
SN - 2077-0383
ER -