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  • Wiley  (8)
  • Mikuls, Ted R.  (8)
  • 1
    Online Resource
    Online Resource
    Validation of the Rheumatic Disease Comorbidity Index
    Wiley ; 2015
    In:  Arthritis Care & Research Vol. 67, No. 6 ( 2015-05), p. 865-872
    Details
    In: Arthritis Care & Research, Wiley, Vol. 67, No. 6 ( 2015-05), p. 865-872
    Abstract: There is no consensus on which comorbidity index is optimal for rheumatic health outcomes research. We compared a new Rheumatic Disease Comorbidity Index (RDCI) with the Charlson‐Deyo Index (CDI), Functional Comorbidity Index (FCI), Elixhauser Total Score (ETS), Elixhauser Point System (EPS), and a simple comorbidity count (COUNT) using a US cohort of rheumatoid arthritis (RA) patients. Methods Using administrative diagnostic codes and patient self‐reporting, we tested predictive values of the RDCI, CDI, FCI, ETS, EPS, and COUNT for 2 outcomes: all‐cause mortality and physical functioning. Indices were compared using 3 models: bare (consisting of age, sex, and race), administrative (bare plus visit frequency, body mass index, and treatments), and clinic (administrative plus erythrocyte sedimentation rate, nodules, rheumatoid factor positivity, and patient activity scale). Results The ETS and RDCI best predicted death, with FCI performing the worst. The FCI best predicted function, with ETS and RDCI performing nearly as well. CDI predicted function poorly. The order of indices remained relatively unchanged in the different models, though the magnitude of improvement in Akaike's information criterion decreased in the administrative and clinic models. Conclusion The RDCI and ETS are excellent indices as a means of accounting for comorbid illness when the RA‐related outcomes of death and physical functioning are studied using administrative data. The RDCI is a versatile index and appears to perform well with self‐report data as well as administrative data. Further studies are warranted to compare these indices using other outcomes in diverse study populations.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Issue
    URL: Article
    DOI: 10.1002/acr.v67.6
    DOI: 10.1002/acr.22456
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2015
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  • 2
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    Body Mass Index, Weight Loss, and Cause‐Specific Mortality in Rheumatoid Arthritis
    Wiley ; 2018
    In:  Arthritis Care & Research Vol. 70, No. 1 ( 2018-01), p. 11-18
    Details
    In: Arthritis Care & Research, Wiley, Vol. 70, No. 1 ( 2018-01), p. 11-18
    Abstract: To examine associations of body mass index ( BMI ) and weight loss with cause‐specific mortality in rheumatoid arthritis ( RA ). Methods A cohort of US veterans with RA was followed until death or through 2013. BMI was categorized as underweight, normal, overweight, and obese. Weight loss was calculated as the 1) annualized rate of change over the preceding 13 months, and 2) cumulative percent. Vital status and cause of death were obtained from the National Death Index. Multivariable competing‐risks regression models were utilized to assess the time‐varying associations of BMI and weight loss with cause‐specific mortality. Results Among 1,600 participants and 5,789 patient‐years of followup, 303 deaths occurred (95 cardiovascular, 74 cancer, and 46 respiratory). The highest weight‐loss rate and weight‐loss percent were associated with a higher risk of cardiovascular mortality (rate: subdistribution hazard ratio [ sHR ] 2.27 [95% confidence interval (95% CI ) 1.61–3.19]; percent: sHR 2.31 [95% CI 1.06–5.01]) and cancer mortality (rate: sHR 2.36 [95% CI 1.11–5.01]; percent: sHR 1.90 [95% CI 1.00–3.62]). Overweight BMI was protective of cardiovascular mortality ( sHR 0.59 [95% CI 0.38–0.91]), while underweight BMI was associated with a near 3‐fold increased risk of respiratory mortality ( sHR 2.93 [95% CI 1.28–6.67]). Incorporation of time‐varying BMI and weight loss in the same models did not substantially alter individual associations for cardiovascular and cancer mortality, but an association between weight‐loss percentage and respiratory mortality was attenuated after BMI adjustment. Conclusion Both BMI and weight loss are predictors of cause‐specific mortality in RA . Weight loss is a strong predictor of cardiovascular and cancer mortality, while underweight BMI is a stronger predictor of respiratory mortality.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Issue
    URL: Article
    DOI: 10.1002/acr.v70.1
    DOI: 10.1002/acr.23258
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2018
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  • 3
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    Cause‐Specific Mortality in Male US Veterans With Rheumatoid Arthritis
    Wiley ; 2016
    In:  Arthritis Care & Research Vol. 68, No. 1 ( 2016-01), p. 36-45
    Details
    In: Arthritis Care & Research, Wiley, Vol. 68, No. 1 ( 2016-01), p. 36-45
    Abstract: There has been limited investigation into cause‐specific mortality and the associated risk factors in men with rheumatoid arthritis (RA). We investigated all‐cause and cause‐specific mortality in men with RA, examining determinants of survival. Methods Men from a longitudinal RA registry were followed from enrollment until death or through 2013. Vital status and cause of death were determined using the National Death Index. Crude mortality rates and standardized mortality ratios (SMRs) were calculated for all‐cause, cardiovascular disease (CVD), cancer, and respiratory mortality. Associations with all‐cause and cause‐specific mortality were examined using multivariable Cox proportional hazards and competing‐risks regression. Results There were 1,652 men with RA and 332 deaths. The leading causes of death were CVD (31.6%; SMR 1.77 [95% confidence interval (95% CI) 1.46–2.14]), cancer (22.9%; SMR 1.50 [95% CI 1.20–1.89] ), and respiratory disease (15.1%; SMR 2.90 [95% CI 2.20–3.83]). Factors associated with all‐cause mortality included older age, white race, smoking, low body weight, comorbidity, disease activity, and prednisone use. Rheuma toid factor concentration and nodules were associated with CVD mortality. There were no associations of methotrexate or biologic agent use with all‐cause or cause‐specific mortality. Conclusion Men in this RA cohort experienced increased all‐cause and cause‐specific mortality, with a 3‐fold risk of respiratory‐related deaths compared to age‐matched men in the general population. Further studies are needed in order to examine whether interventions targeting potentially modifiable correlates of mortality might lead to improved long‐term survival in men with RA.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Issue
    URL: Article
    DOI: 10.1002/acr.v68.1
    DOI: 10.1002/acr.22642
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 4
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    Plasma Matrix Metalloproteinase Concentrations and Risk of Interstitial Lung Disease in a Prospective Rheumatoid Arthritis Cohort
    Wiley ; 2024
    In:  Arthritis & Rheumatology
    Details
    In: Arthritis & Rheumatology, Wiley
    Abstract: To evaluate the associations of plasma matrix metalloproteinases (MMPs) with prevalent and incident interstitial lung disease (ILD) in people with rheumatoid arthritis (RA). Methods Within a multicenter, prospective cohort of US veterans with RA, we performed a cross‐sectional study of prevalent ILD and cohort study of incident ILD. ILD diagnoses were validated by medical record review of provider diagnoses and chest imaging and/or pathology reports. MMP‐1, 3, 7, and 9 concentrations were measured in plasma samples, then standardized and categorized into quartiles. The associations of MMPs with prevalent and incident ILD were assessed with logistic (prevalent) and Cox (incident) regression models adjusted for RA‐ILD risk factors. Results Among 2,312 participants (88.9% male; mean age 63.8 years), 96 had prevalent ILD. Incident ILD developed in 130 participants over 17,378 person‐years of follow‐up (crude incidence rate 7.5/1,000 person‐years). Participants with the highest quartile of MMP‐7 concentrations had a nearly four‐fold increased odds of prevalent ILD (adjusted odds ratio 3.78 [95% confidence interval (95% CI) 1.86–7.65]) and over two‐fold increased risk of incident ILD (adjusted hazard ratio 2.33 [95% CI 1.35–4.02] ). Higher MMP‐9 concentrations were also associated with prevalent and incident ILD, as well as negatively correlated with forced vital capacity among those with prevalent ILD ( r = −0.30, P = 0.005). Conclusion MMP‐7 and MMP‐9 were strongly associated with both prevalent and incident ILD in this large, multicenter RA cohort after adjustment for other RA‐ILD risk factors. These population‐level findings further support a potential pathogenic role for MMPs in RA‐ILD and suggest that their measurement could facilitate RA‐ILD risk stratification.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Article
    DOI: 10.1002/art.42812
    RVK:
    XA 10000
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2024
    detail.hit.zdb_id: 2754614-7
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  • 5
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    Associations of Circulating Cytokines and Chemokines With Cancer Mortality in Men With Rheumatoid Arthritis
    Wiley ; 2016
    In:  Arthritis & Rheumatology Vol. 68, No. 10 ( 2016-10), p. 2394-2402
    Details
    In: Arthritis & Rheumatology, Wiley, Vol. 68, No. 10 ( 2016-10), p. 2394-2402
    Abstract: To examine the potential of circulating cytokines and chemokines as biomarkers of cancer mortality risk in patients with rheumatoid arthritis (RA). Methods Male participants in the Veterans Affairs RA registry were followed up from the time of enrollment until death or December 2013. Cytokines and chemokines were measured in banked serum obtained at the time of enrollment, using a bead‐based multiplex assay, and a previously developed cytokine score was calculated. Vital status and cause of death were determined through the National Death Index. Associations of cytokines with cancer mortality were examined using multivariable competing‐risks regression. Results Among 1,190 men with RA, 60 cancer deaths (30 of which were attributable to lung cancer) occurred over 5,307 patient‐years of follow‐up. The patients had a mean age of 64.5 years, had established disease (median duration 8.7 years), were seropositive for rheumatoid factor (81%) or anti–cyclic citrullinated peptide antibody (77%), and frequently had a history of smoking (82% current or former). Seven of 17 analytes examined were individually associated with cancer mortality. The cytokine score was associated with overall cancer (subhazard ratio [SHR] 1.42, 95% confidence interval [95% CI] 1.08–1.85) and lung cancer (SHR 1.86, 95% CI 1.57–2.19) mortality in multivariable analyses. Those in the highest quartile of cytokine scores had a 〉 2‐fold increased risk of overall cancer mortality ( P  = 0.039) and a 6‐fold increased risk of lung cancer mortality ( P  = 0.028) relative to the lowest quartile. A synergistic interaction between current smoking and high cytokine score was observed. Conclusion Serum cytokines and chemokines are associated with cancer and lung cancer mortality in men with RA, independent of multiple factors including age, smoking status, and prevalent cancer.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
    URL: Article
    DOI: 10.1002/art.v68.10
    DOI: 10.1002/art.39735
    RVK:
    XA 10000
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2016
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  • 6
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    Comparative Profiling of Serum Protein Biomarkers in Rheumatoid Arthritis–Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis
    Wiley ; 2020
    In:  Arthritis & Rheumatology Vol. 72, No. 3 ( 2020-03), p. 409-419
    Details
    In: Arthritis & Rheumatology, Wiley, Vol. 72, No. 3 ( 2020-03), p. 409-419
    Abstract: Interstitial lung disease ( ILD ) is a frequent complication of rheumatoid arthritis ( RA ), occurring in up to 40% of patients during the course of their disease. Early diagnosis is critical, particularly given the shared clinicoepidemiologic features between advanced rheumatoid arthritis–associated ILD ( RA ‐ ILD ) and idiopathic pulmonary fibrosis ( IPF ). This study was undertaken to define the molecular basis of this overlap through comparative profiling of serum proteins in RA ‐ ILD and IPF . Methods Multiplex enzyme‐linked immunosorbent assays ( ELISA s) were used to profile 45 protein biomarkers encompassing cytokines/chemokines, growth factors, and matrix metalloproteinases ( MMP s) in sera obtained from RA patients with ILD and those without, individuals with IPF , and healthy controls. Levels of selected serum proteins were compared between patient subgroups using adjusted linear regression, principal component analysis ( PCA ), and least absolute shrinkage and selection operator ( LASSO ) modeling. Results Multiplex ELISA ‐based assessment of sera from 2 independent cohorts (Veterans Affairs [VA] and Non‐ VA ) revealed a number of non‐overlapping biomarkers distinguishing RA ‐ ILD from RA without ILD ( RA –no ILD ) in adjusted regression models. Parallel analysis of sera from IPF patients also yielded a discriminatory panel of protein markers in models adjusted for age/sex/smoking, which showed differential overlap with profiles linked to RA ‐ ILD in the VA cohort versus the Non‐ VA cohort. PCA revealed several distinct functional groups of RA ‐ ILD –associated markers that, in the VA cohort, encompassed proinflammatory cytokines/chemokines as well as 2 different subsets of MMP s. Finally, LASSO regression modeling in the Non‐ VA and VA cohorts revealed distinct biomarker combinations capable of discriminating RA ‐ ILD from RA –no ILD . Conclusion Comparative serum protein biomarker profiling represents a viable method for distinguishing RA ‐ ILD from RA –no ILD and identifying population‐specific mediators shared with IPF .
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
    URL: Article
    DOI: 10.1002/art.v72.3
    DOI: 10.1002/art.41123
    RVK:
    XA 10000
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2020
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  • 7
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    Coexistent Hyperuricemia and Gout in Rheumatoid Arthritis: Associations With Comorbidities, Disease Activity, and Mortality
    Wiley ; 2020
    In:  Arthritis Care & Research Vol. 72, No. 7 ( 2020-07), p. 950-958
    Details
    In: Arthritis Care & Research, Wiley, Vol. 72, No. 7 ( 2020-07), p. 950-958
    Abstract: Although hyperuricemia and gout can complicate the course of rheumatoid arthritis ( RA ), the impact of these factors on outcomes in RA is unclear. We undertook this study to examine associations of coexistent hyperuricemia and gout with RA disease measures, RA treatments, and survival. Methods Participants from a longitudinal RA study were categorized by the presence of gout and serum urate ( UA ) status. Groups were compared by baseline patient characteristics, RA disease activity, treatments, and comorbidities. Associations of baseline serum UA levels with all‐cause and cardiovascular disease ( CVD )–related mortality were examined in multivariable survival analyses. Results Of 1,999 participants with RA , 341 (17%) had serum UA concentrations of 〉 6.8 mg/dl, and 121 (6.1%) were diagnosed with gout. There were no significant associations of serum UA concentration or gout with RA disease activity or treatment at enrollment, with the exception that those with gout were more likely to be receiving sulfasalazine and less likely to be receiving nonsteroidal antiinflammatory drugs. After adjustments for age and sex, moderate hyperuricemia (serum UA 〉 6.8 to ≤8 mg/dl) was associated with an increased risk of CVD ‐related mortality (hazard ratio 1.56 [95% confidence interval 1.11–2.21]). This association was attenuated and not significant following additional adjustment for comorbidities that more commonly accompany hyperuricemia. Results corresponding with serum UA concentrations of 〉 8.0 mg/dl were similar, although not reaching statistical significance in any model. There were no associations of baseline serum UA concentration with all‐cause mortality. Conclusion Our study reports the frequency of hyperuricemia and gout in patients with RA . These results demonstrate strong associations of hyperuricemia with CVD mortality in this population, a risk that appears to be driven by excess comorbidity.
    Type of Medium: Online Resource
    ISSN: 2151-464X , 2151-4658
    URL: Issue
    URL: Article
    DOI: 10.1002/acr.v72.7
    DOI: 10.1002/acr.23926
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2020
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  • 8
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    Association of Agricultural, Occupational, and Military Inhalants With Autoantibodies and Disease Features in US Veterans With Rheumatoid Arthritis
    Wiley ; 2021
    In:  Arthritis & Rheumatology Vol. 73, No. 3 ( 2021-03), p. 392-400
    Details
    In: Arthritis & Rheumatology, Wiley, Vol. 73, No. 3 ( 2021-03), p. 392-400
    Abstract: To determine the association of inhalant exposures with rheumatoid arthritis (RA)–related autoantibodies and severity in US veterans. Methods Participants in the Veterans Affairs Rheumatoid Arthritis (VARA) registry were mailed surveys assessing occupational, agricultural, and military inhalant exposures. Demographic characteristics, disease activity, functional status, and extraarticular features were obtained from the VARA registry, while HLA–DRB1 shared epitope (SE) status, anti–cyclic citrullinated peptide (anti‐CCP) antibodies, and rheumatoid factor (RF) were measured using banked DNA/serum from enrollment. Associations between inhalant exposures and RA‐related factors (autoantibodies, severity, and extraarticular features) were assessed using multivariable linear and logistic regression models adjusted for age, sex, race, and tobacco use and stratified by SE status. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results Questionnaires were returned by 797 of 1,566 participants (50.9%). Survey respondents were older, more often White or male, and less frequently smokers, and had lower disease activity compared to nonrespondents. Anti‐CCP positivity was more common among veterans exposed to burn pits (OR 1.66 [95% CI 1.02, 2.69]) and military waste disposal (OR 1.74 [95% CI 1.04, 2.93] ) independent of other factors. Among participants who were positive for SE alleles, burn pit exposure (OR 5.69 [95% CI 2.73, 11.87]) and military waste disposal exposure (OR 5.05 [95% CI 2.42, 10.54] ) were numerically more strongly associated with anti‐CCP positivity. Several inhalant exposures were associated with the presence of chronic lung disease, but not with the presence of RF or the level of disease activity. Conclusion Military burn pit exposure and military waste disposal exposure were independently associated with the presence of anti‐CCP antibodies in RA patients. These findings are consistent with emerging evidence that various inhalant exposures influence autoantibody expression and RA risk.
    Type of Medium: Online Resource
    ISSN: 2326-5191 , 2326-5205
    URL: Issue
    URL: Article
    DOI: 10.1002/art.v73.3
    DOI: 10.1002/art.41559
    RVK:
    XA 10000
    RVK:
    XA 30325
    Language: English
    Publisher: Wiley
    Publication Date: 2021
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