Rheumatoid arthritis-related interstitial lung disease (RA-ILD): Clinical, functional features, and variables associated poor initial prognosis in a chilean cohort

Reyes, Felipe; Saavedra, Silvana; Vergara, Karen; Florenzano, Matías; Wolff, Verónica

doi:10.1183/13993003.congress-2020.3481

Cited by 1 publication

(6 citation statements)

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“…For example, some studies found male sex to be associated with RA-ILD (4,24), but others, including ours, did not (10,27,28,30,31). Similarly, smoking has been associated with RA-ILD in some studies (4,11,27,29,32) but not others (10,24,28,30,31). Further, in contrast to some studies (27,(29)(30)(31), our study and others (10,24,31) did not demonstrate an association between seropositivity and RA-ILD.…”

Section: Discussioncontrasting

confidence: 85%

“…Nevertheless, the association between RA‐ILD and all other variables is less compelling. For example, some studies found male sex to be associated with RA‐ILD (4,24), but others, including ours, did not (10,27,28,30,31). Similarly, smoking has been associated with RA‐ILD in some studies (4,11,27,29,32) but not others (10,24,28,30,31).…”

Section: Discussionmentioning

confidence: 62%

“…Similarly, smoking has been associated with RA‐ILD in some studies (4,11,27,29,32) but not others (10,24,28,30,31). Further, in contrast to some studies (27,29–31), our study and others (10,24,31) did not demonstrate an association between seropositivity and RA‐ILD. Interestingly, based on a male‐predominant cohort of US veterans (89% male) with RA, Natalini and colleagues (33) recently reported that combined RF/ACPA seropositivity was associated with prevalent RA‐ILD (i.e., ILD identified prior to or within 12 months after RA onset), but not incident RA‐ILD (i.e., ILD identified more than 12 months after RA onset).…”

Section: Discussionmentioning

confidence: 96%

“…We have found that ever smoking (current or previous) and age at the time of RA incidence, along with the presence of severe EAMs, are the major predictors of incident ILD. Older age at RA onset has been associated with generally worse outcomes (25,26) and has been consistently identified as a predictor of RA-ILD (4,6,10,24,(27)(28)(29)(30). Nevertheless, the association between RA-ILD and all other variables is less compelling.…”

Section: Discussionmentioning

confidence: 99%

“…Older age at RA onset has been associated with generally worse outcomes (25,26) and has been consistently identified as a predictor of RA‐ILD (4,6,10,24,27–30). Nevertheless, the association between RA‐ILD and all other variables is less compelling.…”

Section: Discussionmentioning

confidence: 99%

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Incidence, Risk Factors, and Mortality of Clinical and Subclinical Rheumatoid Arthritis–Associated Interstitial Lung Disease: A Population‐Based Cohort

Samhouri

Vassallo

Achenbach

et al. 2022

Arthritis Care & Research

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To identify the incidence, risk factors, and outcomes of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and to assess time trends in the incidence and mortality in RA-ILD.Methods. We included adult residents of Olmsted County, Minnesota with incident RA between 1999 and 2014. Subjects were followed until death, emigration, or April 30, 2019. ILD was defined as the presence of a radiologistdefined pattern consistent with ILD on chest computed tomography (CT). When chest CT was absent, the combination of chest radiograph abnormalities compatible with ILD and restrictive pattern on pulmonary function testing was considered consistent with ILD. Potential risk factors included age, sex, smoking, obesity, seropositivity, extraarticular manifestations (EAMs), and medications. For survival analysis, we matched RA-ILD patients to RA-non-ILD comparators. The frequency and mortality from clinician-diagnosed RA-ILD from 1999 to 2014 was compared against a cohort from 1955 to 1994.Results. During the 1999-2014 time period, 645 individuals (70% women) had incident RA, were a median age of 55.3 years, and 53% never smoked. Twenty-two patients had ILD before RA, and 51 (67% women) developed ILD during follow-up. The 20-year cumulative incidence of RA-ILD was 15.3%. Ever-smoking (hazard ratio [HR] 1.92), age at RA onset (HR 1.89 per 10-year increase), and severe EAMs (HR 2.29) were associated with incident RA-ILD. The RA-ILD cases had higher mortality than their matched RA comparators (HR 2.42). Incidence of RA-ILD was nonsignificantly lower from 1999 to 2014 than from 1955 to1994, but mortality was improved.Conclusions. RA-ILD occurs in nearly 1 in 6 patients with RA within 20 years and is associated with shorter survival. Lack of significant change in RA-ILD incidence over 6 decades deserves further investigation.The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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