An updated meta-analysis of association of rheumatoid arthritis related interstitial lung disease with anti-cyclic citrullinated peptide antibody or rheumatoid factor

The aim of this updated meta-analysis is to investigate the association between anti-cyclic citrullinated peptide (anti-CCP) antibodies or rheumatoid factor (RF) and rheumatoid arthritis related interstitial lung disease (RA-ILD). We searched the PubMed, Embase, Cochrane and Chinese National Knowledge Infrastructure (CNKI) databases for studies published from inception to December 2014. The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated to assess the strengths of the associations between anti-CCP antibodies or RF and RA-ILD. All of the statistical analyses were performed using Review Manager 5.3 software and STATA 11.0 software. A total of 14 studies involving 702 patients with RA-ILD and 1675 control RA patients were considered. Meta-analysis showed that there was a high association between anti-CCP antibodies and RA-ILD (OR=3.91, 95% CI: 2.62-5.81, P<0.00001). Meanwhile, A high association between RF status and RA-ILD (OR=3.02, 95% CI: 2.37-3.84, P<0.00001) was also observed. In subgroup analyses stratified by ethnicity, highly significant associations were revealed in both the Asian population subgroup (anti-CCP antibodies and RA-ILD: OR=3.72, 95% CI: 2.39-5.81, P<0.00001; RF and RA-ILD: OR=2.66, 95% CI: 1.72-4.12, P<0.0001) and the white population subgroup (anti-CCP antibodies and RA-ILD: OR=3.90, 95% CI: 2.04-7.46, P<0.0001; RF and RA-ILD: OR= 2.84, 95% CI: 1.88-4.31, P<0.00001). Our findings suggest that both anti-CCP antibodies and RF were highly associated with interstitial lung disease in rheumatoid arthritis, in both Asian and white populations.