Novel Biomarkers, Diagnostic and Therapeutic Approach in Rheumatoid Arthritis Interstitial Lung Disease—A Narrative Review

Florescu, Anamaria; Gherghina, Florin Liviu; Mușetescu, Anca Emanuela; Pădureanu, Vlad; Roșu, Anca; Florescu, Mirela Marinela; Criveanu, Cristina; Florescu, Lucian-Mihai; Bobircă, Anca

doi:10.3390/biomedicines10061367

Cited by 21 publications

(18 citation statements)

References 113 publications

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“…One of the main reasons for mortality in RA patients, and the most common kind of lung involvement, is ILD 12 . Quality of life and likelihood of survival in patients with RA or other connective tissue diseases are significantly impacted by lung involvement, according to previous survival studies 19,20 . The theory behind treating RA‐ILD with glucocorticoids and immunosuppressants is that the early pathogenic feature of ILD is the invasion of inflammatory cells, which is followed by fibroblast proliferation and collagen deposition 21 .…”

Section: Discussionmentioning

confidence: 99%

The additional treatment value of immunoglobulin for the treatment of rheumatoid arthritis complicated with interstitial lung disease: A propensity score‐matched pilot study

Wang

2023

Int J of Rheum Dis

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ObjectiveTo explore the additional treatment value of intravenous immunoglobulin injections for treating interstitial lung disease (ILD) caused by rheumatoid arthritis (RA).MethodsThis pilot study included patients with RA‐ILD. The RA‐ILD patients were grouped by treatment agents: traditional agents (disease‐modifying antirheumatic drugs, [D]MARDs] and glucocorticoids) and traditional agents plus immunoglobulin. A propensity matching score (PSM) was performed to balance the bias of baseline characteristics. The treatment efficacy and safety indicators were analyzed and compared between the two groups.ResultsIn total, 134 patients were included in this study. After PSM, 80 patients were finally included, with 40 in each group. The immunoglobulin group consisted of 12 men and 28 women with a mean age of 51.5 ± 8.4 years (22–75 years). The control group included 13 men and 27 women, with a mean age of 50.6 ± 8.2 years (25–74 years). The chronic obstructive pulmonary disease assessment test score in the immunoglobulin group was statistically lower after treatment than in the control group (19.1 ± 3.3 vs. 17.7 ± 3.4, p = .03). The 6‐min walking distance (364.4 ± 54.3 vs. 332.3 ± 55.1, p = .04) and forced vital capacity (78.8 ± 12.6 vs. 66.6 ± 11.2, p = .05) were statistically higher in the immunoglobulin group. The high‐resolution computed tomography score and erythrocyte sedimentation rate were both statistically lower in the immunoglobulin group (both p < .05). The adverse event rate did not differ between the two groups (p = .61).ConclusionThe additional use of immunoglobulin intravenous injection is effective for the treatment of RA‐ILD with no additional adverse effects.

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Section: Discussionmentioning

confidence: 99%

The additional treatment value of immunoglobulin for the treatment of rheumatoid arthritis complicated with interstitial lung disease: A propensity score‐matched pilot study

Wang

2023

Int J of Rheum Dis

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“…Clinical manifestations include interstitial lung disease, small airway disease, rheumatoid nodules, pleural effusion, pulmonary vasculitis, pulmonary fibrosis, etc (69). Although RA can involve many parts of the respiratory system, such as the airway or pleura, parenchymal lung involvement is associated with the highest morbidity and mortality (70). One diagnostic study showed that approximately 50% of RA patients had interstitial lung disease, of which only 10% had clinically significant symptoms such as cough and progressive exertional dyspnea (71), and that is because cytokine, chemotactic factor, and growth factor-mediated RA inflammatory process can promote FLS proliferation, increase the synthesis and deposition of extracellular matrix, and lead to pulmonary fibrosis (72,73).…”

Section: Treatment Of Ra-cvdmentioning

confidence: 99%

Systemic complications of rheumatoid arthritis: Focus on pathogenesis and treatment

Luo

et al. 2022

Front. Immunol.

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As a systemic autoimmune disease, rheumatoid arthritis (RA) usually causes damage not only to joints, but also to other tissues and organs including the heart, kidneys, lungs, digestive system, eyes, skin, and nervous system. Excessive complications are closely related to the prognosis of RA patients and even lead to increased mortality. This article summarizes the serious complications of RA, focusing on its incidence, pathogenesis, clinical features, and treatment methods, aiming to provide a reference for clinicians to better manage the complications of RA.

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“…Kurasawa K. et al consider the titer of these antibodies as a marker of disease activity which can be used to evaluate the efficacy of the treatment [ 33 ]. The level of ferritin, C-reactive protein, Ro-52 antibodies and cutaneous vasculopathy also correlate with the severity of the disease and prognosis [ 5 , 20 , 44 , 61 , 62 , 63 ].…”

Section: Prognosismentioning

confidence: 99%

Anti-MDA5 Amyopathic Dermatomyositis—A Diagnostic and Therapeutic Challenge

Bobircă

Alexandru

Mușetescu

et al. 2022

Life

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Clinically amyopathic Dermatomyositis (CADM) is a rare subtype of idiopathic inflammatory myositis, associated with no muscular manifestations, which is more frequent in Asian women. Anti-melanoma differentiation-associated gene 5 (MDA5) antibodies are a recently discovered type of specific autoantibodies associated with myositis. The anti-MDA5 DM was initially described in Japan and later it was discovered that the target antigen was a protein implicated in the innate immune response against viruses, that is encoded by the melanoma differentiation-associated gene 5. Anti-MDA5 DM is characteristically associated with distinguished mucocutaneus and systemic manifestations, including skin ulcerations, palmar papules, arthritis, and interstitial-lung disease. Patients with anti-MDA5 positivity have a high risk of developing rapid progressive interstitial-lung disease (RP-ILD), with a poor outcome. As a result, despite high mortality, diagnosis is often delayed, necessitating increased awareness of this possible condition. Despite a severe course of lung disease and an increased mortality rate, there is currently no standard treatment. Recent insights based on observational studies and case reports support combined therapy with immunosuppressive drugs and corticotherapy, as soon as the symptoms appear. The aim of this paper is to describe anti-MDA5 DM, focusing on the recent literature about the unique clinical manifestations and therapeutic options, starting from a severe clinical case diagnosed in our Rheumatology Department.

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Novel Biomarkers, Diagnostic and Therapeutic Approach in Rheumatoid Arthritis Interstitial Lung Disease—A Narrative Review

Cited by 21 publications

References 113 publications

The additional treatment value of immunoglobulin for the treatment of rheumatoid arthritis complicated with interstitial lung disease: A propensity score‐matched pilot study

The additional treatment value of immunoglobulin for the treatment of rheumatoid arthritis complicated with interstitial lung disease: A propensity score‐matched pilot study

Systemic complications of rheumatoid arthritis: Focus on pathogenesis and treatment

Anti-MDA5 Amyopathic Dermatomyositis—A Diagnostic and Therapeutic Challenge

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