Interstitial lung diseases induced or exacerbated by DMARDS and biologic agents in rheumatoid arthritis: A systematic literature review

Roubille, Camille; Haraoui, Boulos

doi:10.1016/j.semarthrit.2013.09.005

Cited by 255 publications

(187 citation statements)

References 119 publications

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“…Rare cases of JC virusassociated progressive multifocal leukoencephalopathy have been reported in rituximab-treated patients (reported incidence ,1:20,000 with extensive use in rheumatoid arthritis [26]), but it is not clear whether there is a true association between rituximab and development of progressive multifocal leukoencephalopathy. Noninfectious pulmonary toxicity has also been reported in rituximabtreated patients (three cases reported in patients with rheumatoid arthritis) (48,49).…”

Section: Additional Treatment-specific Adverse Eventsmentioning

confidence: 99%

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

Hogan

Avasare

2014

Clinical Journal of the American Society of Nephrology

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Clinical outcomes in ANCA-associated vasculitis (AAV) and lupus nephritis have improved greatly with treatment regimens containing high-dose glucocorticoids and cyclophosphamide. However, with the use of these medications come significant adverse events, most notably infections, cytopenias, malignancies, and reproductive abnormalities. Multiple recent randomized controlled trials in AAV and lupus nephritis have compared cyclophosphamide-based regimens with agents such as rituximab, mycophenolate mofetil, and azathioprine, with the hope of providing better clinical outcomes with improved safety profiles. Although some of these newer regimens are now considered first-line treatments of these diseases, their adverse event profiles have been disappointingly similar to those of cyclophosphamide-based protocols. Physicians and patients should consider the adverse event profiles generated by these trials in the context of their extensive use in other patient populations, as well as available measures to prevent such events, when choosing the ideal regimen for an individual patient.

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Section: Additional Treatment-specific Adverse Eventsmentioning

confidence: 99%

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

Hogan

Avasare

2014

Clinical Journal of the American Society of Nephrology

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“…In fact, in the majority of cases they represent the first treatment option 39 . However, an increasing number of reports have appeared regarding the lung toxicity of this group of drugs 40 . Methotrexate is the most utilized and paradigmatic drug from this group, and the occurrence of lung disease in patients receiving this drug has also been reported.…”

Section: Extrapolating From the Treatment Of Other Manifestations Ofmentioning

confidence: 99%

“…This fact has generated confusion regarding the use of this agent in patients with RA ILD. The reported lung toxicity with methotrexate is of two different types: an acute hypersensitivity pneumonitis and a chronic ILD 40 . Nevertheless, some interesting aspects should be considered.…”

Section: Extrapolating From the Treatment Of Other Manifestations Ofmentioning

confidence: 99%

Practical Approach to the Evaluation and Management of Rheumatoid Arthritis-Interstitial Lung Disease based on its Proven and Hypothetical Mechanisms

Paulín

Babini

Mamani

et al. 2017

RIC

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The prevalence of interstitial lung disease in patients with rheumatoid arthritis varies from 10 to 42%. Rheumatoid arthritis patients with interstitial lung disease have three times the risk of death compared with those without the disease. Prognosis seems to be related to the high-resolution computed tomography pattern. Usual interstitial pneumonia pattern, resembling idiopathic pulmonary fibrosis, carries a worse prognosis. Validated strategies to identify different phenotypes and assess the disease activity in rheumatoid arthritis interstitial lung disease are lacking. However, the utilization of high-resolution computed tomography, composed disease activity scores, and anti-citrullinated peptide antibodies titers can help to guide decisions in clinical practice. Mechanisms involved in lung disease may be different from those implicated in joint involvement. This could explain why in a significant proportion of cases, interstitial lung disease does not improve or even worsens with standard therapies used successfully to treat the joint component (e.g. anti-tumor necrosis factor agents). In this scenario, a group of drugs that targets the adaptive immune response (e.g. rituximab or abatacept) seems to target more specifically the process that takes place in the lungs. Moreover, the recent emergence of anti-fibrotic drugs, which have already proven effective in idiopathic pulmonary fibrosis, may provide an alternative treatment strategy in rheumatoid arthritis-usual interstitial pneumonia. In this review, we propose a practical approach to the evaluation and therapy of rheumatoid arthritis interstitial lung disease. Validation of strategies directed to assess the activity of lung disease and identify the underlying mechanisms are needed. Clinical trials evaluating a therapeutic approach with specific targets based on the disease phenotype are warranted.

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“…33,34 Since these agents are used in severe RA disease and reported ILD cases are rare, it is difficult to determine the exact incidence of drug-related new onset ILD or worsening of pre-existing ILD due to these agents. 35 The largest database of RA patients on biologics comes from the British Society for Rheumatology Biologics Registry (BSRBR). This registry includes over 8000 patients with RA who are on biologics; the purpose of the registry is to monitor the benefits and side effects related to biological drugs for RA.…”

Section: Biological Agentsmentioning

confidence: 99%

“…A prospective study on a small subgroup of these patients suggested that biologics do not increase overall mortality, but ILD seems to be a more common cause of death in patients on biologics than in patients on DMARDs. 35,37 Granulomatous lung disease in patients on biologics, especially TNFα inhibitors, present with cough, shortness of breath, and chest pain; single, multiple, and cavitary nodules has been described in case reports and case series. Discontinuation of these agents resulted in resolution of disease in most of the cases.…”

Section: Biological Agentsmentioning

confidence: 99%

The effect of disease modifying drugs on the lung in patients with rheumatoid arthritis

2016

SWRCCC

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Interstitial lung diseases induced or exacerbated by DMARDS and biologic agents in rheumatoid arthritis: A systematic literature review

Cited by 255 publications

References 119 publications

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

Is Newer Safer? Adverse Events Associated with First-Line Therapies for ANCA-Associated Vasculitis and Lupus Nephritis

Practical Approach to the Evaluation and Management of Rheumatoid Arthritis-Interstitial Lung Disease based on its Proven and Hypothetical Mechanisms

The effect of disease modifying drugs on the lung in patients with rheumatoid arthritis

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