Association between sinusitis and incident rheumatic diseases: a population-based study

Objectives To determine whether antecedent sinusitis is associated with incident rheumatic disease.Methods This population-based case–control study included all individuals meeting classification criteria for rheumatic diseases between 2002 and 2014. We matched three controls to each case on age, se...

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Main Authors: Ali Duarte-García, Kenneth J Warrington, Ashima Makol, Elena Myasoedova, Cynthia S Crowson, Jeffrey A Sparks, John M Davis, Vanessa L Kronzer, Andrew C Hanson, Robert Vassallo, Mattew J Koster, Alicia M Hinze, Kerry Wright
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:RMD Open
Online Access:https://rmdopen.bmj.com/content/10/1/e003622.full
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Summary:Objectives To determine whether antecedent sinusitis is associated with incident rheumatic disease.Methods This population-based case–control study included all individuals meeting classification criteria for rheumatic diseases between 2002 and 2014. We matched three controls to each case on age, sex and length of prior electronic health record history. The primary exposure was presence of sinusitis, ascertained by diagnosis codes (positive predictive value 96%). We fit logistic regression models to estimate ORs for incident rheumatic diseases and disease groups, adjusted for confounders.Results We identified 1427 incident rheumatic disease cases and 4281 matched controls (mean age 63, 67% women, median 14 years electronic health record history). After adjustment, preceding sinusitis was associated with increased risk of several rheumatic diseases, including antiphospholipid syndrome (OR 7.0, 95% CI 1.8 to 27), Sjögren’s disease (OR 2.4, 95% CI 1.1 to 5.3), and any rheumatic disease (OR 1.4, 95% CI 1.2 to 1.7). Acute sinusitis was also associated with increased risk of seronegative rheumatoid arthritis (OR 1.8, 95% CI 1.1 to 3.1). Sinusitis was most associated with any rheumatic disease in the 5–10 years before disease onset (OR 1.7, 95% CI 1.3 to 2.3). Individuals with seven or more codes for sinusitis had the highest risk for rheumatic disease (OR 1.7, 95% CI 1.2 to 2.4). In addition, the association between sinusitis and incident rheumatic diseases showed the highest point estimates for never smokers (OR 1.7, 95% CI 1.3 to 2.3).Conclusions Preceding sinusitis is associated with increased incidence of rheumatic diseases, suggesting a possible role for sinus inflammation in their pathogenesis.
ISSN:2056-5933