Association of rheumatoid arthritis with hearing loss: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 32488430 · doi:10.1007/s00296-020-04609-1
What was done
A systematic review and random-effects meta-analysis following PRISMA guidelines assessed the association between rheumatoid arthritis (RA) and subtypes of hearing loss (sensorineural, conductive, and mixed). Twelve observational studies comprising 20,022 RA patients and 79,244 controls were included. Heterogeneity was evaluated using the I^2 statistic.
What was found
RA was significantly associated with sensorineural hearing loss (SNHL), showing increased odds (OR 3.42, 95% CI 2.50–4.69; I^2 = 13%) and increased risk (RR 2.28, 95% CI 1.88–2.76; I^2 = 0%). RA was not significantly associated with conductive hearing loss (OR 1.36, 95% CI 0.52–3.55; I^2 = 22%) or mixed hearing loss (OR 2.73, 95% CI 0.78–9.58; I^2 = 0%).
Why it matters
This study establishes sensorineural hearing loss as a significant potential extra-articular manifestation of rheumatoid arthritis, supporting consideration of audiometric screening in these patients.
Limits
All included studies were observational and evaluated as having a moderate risk of bias. The abstract does not report whether analyses adjusted for potential confounders, such as patient age, disease duration, or exposure to ototoxic medications.
Cited by
- supports Individuals with autoimmune conditions such as rheumatoid arthritis or celiac disease have an increased risk of hearing loss due to inner ear injury and fixation of middle ear ossicular joints.