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TOPLINE:

New findings reveal that rheumatoid arthritis (RA) disease activity significantly affects the severity of interstitial lung disease (ILD), both radiologically and physiologically, in patients with RA and comorbid ILD.

METHODOLOGY:

• Impaired pulmonary function negatively affects the survival of patients with RA-ILD, making it necessary to evaluate the effect of RA disease activity on the severity of ILD.
• Researchers assessed the associations between RA disease activity and ILD severity in 124 patients with RA (median age, 70.0 years; 25.8% men; median disease duration, 2.92 years) who visited a rheumatology center between December 2020 and March 2023.
• ILD severity was determined using high-resolution computed tomography (HRCT), with scores ranging from 0% (no involvement) to 100% (all lung fields affected), and pulmonary function tests such as forced vital capacity (FVC) and predicted FVC%.
• RA disease activity was assessed using the Disease Activity Score in 28 joints calculated with erythrocyte sedimentation rate (DAS28-ESR) and the Clinical Disease Activity Index (CDAI).

TAKEAWAY:

• HRCT revealed that 17 patients had ILD, with ILD severity being mild (< 10% lung involvement), moderate (≥ 10% to < 20%), or severe (≥ 20%) in 7.2%, 2.4%, and 4.0% patients, respectively.
• Both rheumatoid factor titer (standardized coefficient, 0.247; P = .01) and DAS28-ESR (standardized coefficient, 0.199; P = .03) were significantly associated with the radiological quantitative severity of ILD.
• Additionally, DAS28-ESR showed a significant association with predicted FVC% (standardized coefficient, −0.230; P = .047); however, no significant association was observed with CDAI.

IN PRACTICE:

The authors concluded that RA disease activity significantly affects the severity of ILD, both radiologically and physiologically.

SOURCE:

This study, led by Yuhei Ito, MD, Centre for Rheumatic Diseases, Mie University Hospital, Tsu, Japan, was published online on May 4 in Arthritis Research & Therapy.

LIMITATIONS:

This single-center study included a small number of patients with ILD. Not all patients without ILD underwent pulmonary function tests. The effect of treatment-related changes in RA disease activity on the progression of ILD was not assessed because of the cross-sectional nature of the study.

DISCLOSURES:

The study was supported by Nippon Boehringer Ingelheim, Chugai, and Mitsubishi Tanabe Pharma. The authors declared having no conflicts of interest.