Family History of Some Conditions May Increase Risk for Rheumatoid Arthritis

A family history of several autoimmune and non‐autoimmune conditions including thyroid disease and inflammatory bowel disease is associated with elevated risk of developing rheumatoid arthritis in some patients. This finding could help identify new populations at risk of rheumatoid arthritis, improve disease risk prediction tools, and potentially uncover new details regarding rheumatoid arthritis pathogenesis, according to a study published in Arthritis Care & Research.

This case-control study used data from the Mayo Clinic Biobank to determine the association between a family history of 79 unique comorbidities and rheumatoid arthritis. Each of the 821 cases of rheumatoid arthritis identified by researchers were matched to 3 controls based on sex, age, location, and recruitment year. Family history and potential confounding variables were all self-reported. Odds ratios (OR) and confidence intervals (CI) for rheumatoid arthritis risk determined by presence of family history for each comorbidity were estimated using logistic regression adjusted for body mass index, race, education, age, sex, and smoking.

Self-reported family history of rheumatoid arthritis in a first-degree relative was associated with the development of rheumatoid arthritis (adjusted OR [aOR], 2.44; 95% CI, 2.02-2.94), as was family history of several other conditions including hyper/hypothyroidism (aOR, 1.34; 95% CI, 1.10-1.63), osteoarthritis (aOR, 1.41; 95% CI, 1.19-1.68), and rheumatologic autoimmune diseases (aOR, 1.89; 95% CI, 1.41-2.52). Although family history of type 2 diabetes and Parkinson disease were associated with a decreased risk of rheumatoid arthritis, this figure did not reach the statistically significant, prespecified threshold of P <.01. Similarly, a family history of several other comorbidities was associated with developing RA, including fibromyalgia, inflammatory bowel disease, pulmonary fibrosis, obstructive sleep apnea, and migraine headaches, but not at the prespecified threshold of P <.01. None of the cancer family history items were associated with developing rheumatoid arthritis, even when the items were combined (aOR, 0.97; 95% CI, 0.81-1.16).

Study limitations include the use of a convenience sample, potential for recall bias, fact that participants were not asked about individual diseases, and high nonresponse for each family history item.

Study investigators conclude, “These findings can help refine tools to predict RA risk. Future studies exploring the mechanisms for such associations may help uncover RA disease pathogenesis.”

Reference

Kronzer VL, Crowson CS, Sparks JA, Myasoedova E, Davis J 3rd. Family history of rheumatologic, autoimmune, and non-autoimmune diseases and risk of rheumatoid arthritis [published online November 30, 2019]. Arthritis Care Res. doi: 10.1002/acr.24115