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Association of rheumatoid arthritis with hearing loss: a systematic review and meta-analysis

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Abstract

Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting up to 1% of the worldwide population. RA is associated with multiple extra-articular manifestations (EAMs). Middle ear, cochlea and the auditory nerve are suspected sites of RA activity and hearing loss is a possible novel EAM of RA. Objective was to investigate the association of RA with the different subtypes of hearing loss. This systematic review was performed according to the PRISMA guidelines. A random effects model meta-analysis was conducted and the I2 was used to assess heterogeneity. Twelve studies comprising 20,022 RA patients and 79,244 controls were included in this systematic review. All studies were observational and were rated to a moderate rate of bias. RA patients had nearly fourfold increased odds of sensorineural hearing loss (SNHL) compared with controls (OR 3.42; 95% CI 2.50–4.69; I2 = 13). RA patients also had a significantly increased risk of SNHL (RR 2.28; 95% CI 1.88–2.76; I2 = 0). RA patients did not have increased odds of conductive hearing loss (CHL) and mixed hearing loss (MHL) (OR 1.36; 95% CI 0.52–3.55; I2 = 22); (OR 2.73; 95% CI 0.78–9.58; I2 = 0%). RA is significantly associated with SNHL. RA is not associated with CHL and MHL. Early screening of RA patients with pure tone audiometry should be considered.

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References

  1. MacGregor AJ, Snieder H, Rigby AS et al (2000) Characterizing the quantitative genetic contribution to rheumatoid arthritis using data from twins. Arthritis Rheum 43:30–37. https://doi.org/10.1002/1529-0131(200001)43:1%3c30:AID-ANR5%3e3.0.CO;2-B

    Article  CAS  PubMed  Google Scholar 

  2. Gregersen PK, Silver J, Winchester RJ (1987) The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis. Arthritis Rheum 30:1205–1213. https://doi.org/10.1002/art.1780301102

    Article  CAS  PubMed  Google Scholar 

  3. The Wellcome Trust Case Control Consortium (2007) Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls. Nature 447:661–678. https://doi.org/10.1038/nature05911

    Article  CAS  PubMed Central  Google Scholar 

  4. Smolen JS, Aletaha D, McInnes IB (2016) Rheumatoid arthritis. Lancet (Lond, Engl) 388:2023–2038. https://doi.org/10.1016/S0140-6736(16)30173-8

    Article  CAS  Google Scholar 

  5. Myasoedova E, Crowson CS, Turesson C et al (2011) Incidence of extraarticular rheumatoid arthritis in Olmsted County, Minnesota, in 1995–2007 versus 1985–1994: a population-based study. J Rheumatol 38:983–989. https://doi.org/10.3899/jrheum.101133

    Article  PubMed  PubMed Central  Google Scholar 

  6. Cimmino MA, Salvarani C, Macchioni P et al (2000) Extra-articular manifestations in 587 Italian patients with rheumatoid arthritis. Rheumatol Int 19:213–217. https://doi.org/10.1007/pl00006853

    Article  CAS  PubMed  Google Scholar 

  7. Lobo FS, Dossi MO, Batista L, Shinzato MM (2016) Hearing impairment in patients with rheumatoid arthritis: association with anti-citrullinated protein antibodies. Clin Rheumatol 35:2327–2332. https://doi.org/10.1007/s10067-016-3278-x

    Article  PubMed  Google Scholar 

  8. Halligan CS, Bauch CD, Brey RH et al (2006) Hearing loss in rheumatoid arthritis. Laryngoscope 116:2044–2049. https://doi.org/10.1097/01.mlg.0000241365.54017.32

    Article  PubMed  Google Scholar 

  9. Takatsu M, Higaki M, Kinoshita H et al (2005) Ear involvement in patients with rheumatoid arthritis. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol 26:755–761. https://doi.org/10.1097/01.mao.0000178138.19848.bd

    Article  Google Scholar 

  10. Ozturk A, Yalcin S, Kaygusuz I et al (2004) High-frequency hearing loss and middle ear involvement in rheumatoid arthritis. Am J Otolaryngol 25:411–417. https://doi.org/10.1016/j.amjoto.2004.06.001

    Article  PubMed  Google Scholar 

  11. Ozcan M, Karakus MF, Gunduz OH et al (2002) Hearing loss and middle ear involvement in rheumatoid arthritis. Rheumatol Int 22:16–19. https://doi.org/10.1007/s00296-002-0185-z

    Article  PubMed  Google Scholar 

  12. Reiter D, Konkle DF, Myers AR et al (1980) Middle ear immittance in rheumatoid arthritis. Arch Otolaryngol 106:114–117. https://doi.org/10.1001/archotol.1980.00790260046013

    Article  CAS  PubMed  Google Scholar 

  13. Galarza-Delgado DA, Villegas Gonzalez MJ, Riega Torres J et al (2018) Early hearing loss detection in rheumatoid arthritis and primary Sjogren syndrome using extended high frequency audiometry. Clin Rheumatol 37:367–373. https://doi.org/10.1007/s10067-017-3959-0

    Article  PubMed  Google Scholar 

  14. Golub JS, Brickman AM, Ciarleglio AJ et al (2019) Association of subclinical hearing loss with cognitive performance. JAMA Otolaryngol Head Neck Surg 146:57–67. https://doi.org/10.1001/jamaoto.2019.3375

    Article  Google Scholar 

  15. Michalowsky B, Hoffmann W, Kostev K (2019) Association between hearing and vision impairment and risk of dementia: results of a case-control study based on secondary data. Front Aging Neurosci 11:363. https://doi.org/10.3389/fnagi.2019.00363

    Article  PubMed  PubMed Central  Google Scholar 

  16. Shamseer L, Moher D, Clarke M et al (2015) Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 350:g7647

    Article  Google Scholar 

  17. Higgins JPT, Altman DG, Gotzsche PC et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928. https://doi.org/10.1136/bmj.d5928

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sterne JA, Hernan MA, Reeves BC et al (2016) ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 355:i4919

    Article  Google Scholar 

  19. Sterne JAC, Sutton AJ, Ioannidis JPA et al (2011) Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 343:d4002. https://doi.org/10.1136/bmj.d4002

    Article  PubMed  Google Scholar 

  20. The Cochrane Collaboration (2014) Review manager (RevMan) [computer program]. Version 5.3. The Nordic Cochrane Centre, Copenhagen

  21. Garcia Callejo FJ, Conill Tobias N, Munoz Fernandez N et al (2007) Hearing impairment in patients with rheumatoid arthritis. Acta Otorrinolaringol Esp 58:232–238

    Article  Google Scholar 

  22. Ahmadzadeh A, Daraei M, Jalessi M et al (2017) Hearing status in patients with rheumatoid arthritis. J Laryngol Otol 131:895–899. https://doi.org/10.1017/S0022215117001670

    Article  CAS  PubMed  Google Scholar 

  23. Huang C-M, Chen H-J, Huang P-H et al (2018) Retrospective cohort study on risk of hearing loss in patients with rheumatoid arthritis using claims data. BMJ Open 8:e018134. https://doi.org/10.1136/bmjopen-2017-018134

    Article  PubMed  PubMed Central  Google Scholar 

  24. Jeong J, Lim H, Lee K et al (2019) High risk of sudden sensorineural hearing loss in several autoimmune diseases according to a population-based national sample cohort study. Audiol Neurootol 24:224–230. https://doi.org/10.1159/000502677

    Article  PubMed  Google Scholar 

  25. Raut VV, Cullen J, Cathers G (2001) Hearing loss in rheumatoid arthritis. J Otolaryngol 30:289–294. https://doi.org/10.2310/7070.2001.19580

    Article  CAS  PubMed  Google Scholar 

  26. Dikici O, Muluk NB, Tosun AK, Unlusoy I (2009) Subjective audiological tests and transient evoked otoacoustic emissions in patients with rheumatoid arthritis: analysis of the factors affecting hearing levels. Eur Arch Otorhinolaryngol 266:1719–1726. https://doi.org/10.1007/s00405-009-0975-y

    Article  PubMed  Google Scholar 

  27. Rosenberg JN, Moffat DA, Ramsden RT et al (1978) Middle ear function in rheumatoid arthritis. Ann Rheum Dis 37:522–524. https://doi.org/10.1136/ard.37.6.522

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Bhatt KA, Liberman MC, Nadol JBJ (2001) Morphometric analysis of age-related changes in the human basilar membrane. Ann Otol Rhinol Laryngol 110:1147–1153. https://doi.org/10.1177/000348940111001212

    Article  CAS  PubMed  Google Scholar 

  29. Viana LM, O’Malley JT, Burgess BJ et al (2015) Cochlear neuropathy in human presbycusis: confocal analysis of hidden hearing loss in post-mortem tissue. Hear Res 327:78–88. https://doi.org/10.1016/j.heares.2015.04.014

    Article  PubMed  PubMed Central  Google Scholar 

  30. Zhu T, Feng L (2013) Comparison of anti-mutated citrullinated vimentin, anti-cyclic citrullinated peptides, anti-glucose-6-phosphate isomerase and anti-keratin antibodies and rheumatoid factor in the diagnosis of rheumatoid arthritis in Chinese patients. Int J Rheum Dis 16:157–161. https://doi.org/10.1111/1756-185X.12040

    Article  CAS  PubMed  Google Scholar 

  31. Li L, Deng C, Chen S et al (2016) Meta-analysis: diagnostic accuracy of anti-carbamylated protein antibody for rheumatoid arthritis. PLoS ONE 11:e0159000. https://doi.org/10.1371/journal.pone.0159000

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Makol A, Crowson CS, Wetter DA et al (2014) Vasculitis associated with rheumatoid arthritis: a case-control study. Rheumatology (Oxf) 53:890–899. https://doi.org/10.1093/rheumatology/ket475

    Article  CAS  Google Scholar 

  33. Voskuyl AE, Zwinderman AH, Westedt ML et al (1996) Factors associated with the development of vasculitis in rheumatoid arthritis: results of a case-control study. Ann Rheum Dis 55:190–192. https://doi.org/10.1136/ard.55.3.190

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Ashok Murthy V, Mohan Kumar J (2012) Rheumatoid factor and hearing loss. Indian J Otolaryngol Head Neck Surg 64:364–365. https://doi.org/10.1007/s12070-011-0401-9

    Article  CAS  PubMed  Google Scholar 

  35. Bayazit YA, Yilmaz M, Gunduz B et al (2007) Distortion product otoacoustic emission findings in Behcet’s disease and rheumatoid arthritis. ORL J Otorhinolaryngol Relat Spec 69:233–238. https://doi.org/10.1159/000101544

    Article  PubMed  Google Scholar 

  36. Di Stadio A, Ralli M (2017) Systemic lupus erythematosus and hearing disorders: literature review and meta-analysis of clinical and temporal bone findings. J Int Med Res 45:1470–1480. https://doi.org/10.1177/0300060516688600

    Article  PubMed  PubMed Central  Google Scholar 

  37. Souliotis VL, Vlachogiannis NI, Pappa M et al (2019) DNA damage response and oxidative stress in systemic autoimmunity. Int J Mol Sci. https://doi.org/10.3390/ijms21010055

    Article  PubMed  PubMed Central  Google Scholar 

  38. Bougea A, Anagnostou E, Konstantinos G et al (2015) A systematic review of peripheral and central nervous system involvement of rheumatoid arthritis, systemic lupus erythematosus, primary Sjogren’s syndrome, and associated immunological profiles. Int J Chronic Dis 2015:910352. https://doi.org/10.1155/2015/910352

    Article  PubMed  PubMed Central  Google Scholar 

  39. Barbieri MA, Cicala G, Cutroneo PM et al (2019) Ototoxic adverse drug reactions: a disproportionality analysis using the italian spontaneous reporting database. Front Pharmacol 10:1161. https://doi.org/10.3389/fphar.2019.01161

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Kyle ME, Wang JC, Shin JJ (2015) Impact of nonaspirin nonsteroidal anti-inflammatory agents and acetaminophen on sensorineural hearing loss: a systematic review. Otolaryngol neck Surg Off J Am Acad Otolaryngol Neck Surg 152:393–409. https://doi.org/10.1177/0194599814564533

    Article  Google Scholar 

  41. Magaro M, Zoli A, Altomonte L et al (1990) Sensorineural hearing loss in rheumatoid arthritis. Clin Exp Rheumatol 8:487–490

    CAS  PubMed  Google Scholar 

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Acknowledgements

We do not have any financial relationship to this article.

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We did not receive any funding to conduct this study.

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Authors and Affiliations

  1. Hellenic Army Medical Corps, Kastoria, Greece

    Nikolaos Chaitidis

  2. Hellenic Police Medical Center, Thessaloníki, Greece

    Patroklos Theocharis

  3. Department of Otorhinolaryngology, 401 General Military Hospital of Athens, Athens, Greece

    Charalampos Festas

  4. Department of Surgery, General Hospital of Kastoria, Kastoria, Greece

    Ioanna Aritzi

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  1. Nikolaos Chaitidis
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  4. Ioanna Aritzi
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Contributions

CN conceptualized, proposed and designed the study. FC and AI searched the literature, screened and selected the eligible studies.CN and TP assessed the quality of the studies included. CN and TP analyzed the data and carried out the statistical analyses. CN and TP contributed in drafting the manuscript, and all other authors reviewed it critically. All authors revised the final manuscript and approved it for publication submission. All authors agree to be accountable for all aspects of the work in ensuring that questions related to quality of the work are appropriately examined and resolved.

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Correspondence to Nikolaos Chaitidis.

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Chaitidis, N., Theocharis, P., Festas, C. et al. Association of rheumatoid arthritis with hearing loss: a systematic review and meta-analysis. Rheumatol Int 40, 1771–1779 (2020). https://doi.org/10.1007/s00296-020-04609-1

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  • DOI: https://doi.org/10.1007/s00296-020-04609-1

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