{"doi":"10.1002/acr.70008","title":"Combining Three Peripheral Blood Biomarkers to Stratify Rheumatoid Arthritis–Associated Interstitial Lung Disease Risk","abstract":"OBJECTIVE: The purpose was to evaluate a biomarker score consisting of MUC5B rs35705950 promoter variant, plasma matrix metalloproteinase-7 (MMP-7), and serum anti-malondialdehyde-acetaldehyde (anti-MAA) antibody for rheumatoid arthritis (RA)-associated interstitial lung disease (ILD) risk stratification. METHODS: Using a multicenter cohort of US veterans with RA, we performed a cross-sectional study of prevalent RA-ILD and a cohort study of incident RA-ILD. Medical records were used to confirm clinical ILD diagnoses by chest imaging or lung biopsy pathology reports. A combined three-biomarker score (range 0-3) was calculated based on the presence of the MUC5B variant and elevations (upper 25% vs lower 75%) in MMP-7 and anti-MAA antibody concentrations. Multivariate logistic and Cox regression models were adjusted for clinical risk factors. RESULTS: Among 2,043 participants with RA, prevalent ILD was identified in 88 (88.7% male; mean age 63.6 years). The odds of prevalent RA-ILD were higher with increased biomarker score (adjusted odds ratio 12.21 [95% confidence interval (CI) 3.82-38.97] for score of 3 vs 0). A score ≥1 had 76.1% sensitivity but 48.6% specificity. Incident RA-ILD developed in 148 participants, with those having a combined biomarker score of 3 having the highest risk (adjusted hazard ratio 4.36 [95% CI 1.55-12.27]). The area under the curve for prevalent RA-ILD and Harrell's C for incident RA-ILD were highest when clinical risk factors were combined with the biomarker score. CONCLUSION: This three-analyte biomarker score was associated with both prevalent and incident RA-ILD, improving risk stratification beyond clinical risk factors. Although this score is inadequate for clinical implementation, these findings demonstrate the potential for biomarker scores in RA-ILD risk stratification.","journal":"Arthritis Care & Research","year":2025,"id":549432,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9399,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":870119,"name":"Austin M. Wheeler","orcid":"0000-0002-8816-7782","position":1,"is_corresponding":false},{"id":443092,"name":"Brent A. Luedders","orcid":"0000-0001-6717-9680","position":2,"is_corresponding":false},{"id":366000,"name":"Michael J. Duryee","orcid":"0000-0001-9104-2238","position":3,"is_corresponding":false},{"id":1368082,"name":"Halie Frideres","orcid":"0009-0008-1752-0949","position":4,"is_corresponding":false},{"id":497055,"name":"Katherine D. Wysham","orcid":"0000-0001-8707-7649","position":5,"is_corresponding":false},{"id":755682,"name":"Grant W. Cannon","orcid":"0000-0001-6640-9173","position":6,"is_corresponding":false},{"id":862588,"name":"Gary Kunkel","orcid":null,"position":7,"is_corresponding":false},{"id":685291,"name":"Dana P. Ascherman","orcid":"0000-0002-1387-0860","position":8,"is_corresponding":false},{"id":61593,"name":"Paul A. Monach","orcid":"0000-0003-4937-0515","position":9,"is_corresponding":false},{"id":755681,"name":"Gail S. Kerr","orcid":"0000-0002-4930-3235","position":10,"is_corresponding":false},{"id":372692,"name":"Andreas Reimold","orcid":null,"position":11,"is_corresponding":false},{"id":476885,"name":"Scott M. Matson","orcid":"0000-0002-3748-9597","position":12,"is_corresponding":false},{"id":1364965,"name":"Joshua F. Baker","orcid":"0000-0003-0170-028X","position":13,"is_corresponding":false},{"id":342502,"name":"Geoffrey M. Thiele","orcid":"0000-0001-5688-8596","position":14,"is_corresponding":false},{"id":314417,"name":"Ted R. Mikuls","orcid":"0000-0002-0897-2272","position":15,"is_corresponding":false},{"id":314415,"name":"Bryant R. England","orcid":"0000-0002-9649-3588","position":16,"is_corresponding":false},{"id":1443650,"name":"Kelsey Coziahr","orcid":"0009-0005-2342-306X","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:54:07.823422Z","pmid":"41392523","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}