RT Journal Article
T1 Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study
A1 Mena-Vázquez, Natalia
A1 Rojas-Gimenez, Marta
A1 Romero-Barco, Carmen María
A1 Manrique-Arija, Sara
A1 Francisco, Espildora
A1 Aguilar-Hurtado, María Carmen
A1 Añón-Oñate, Isabel
A1 Pérez-Albaladejo, Lorena
A1 Ortega-Castro, Rafaela
A1 Godoy-Navarrete, Francisco Javier
A1 Ureña-Garnica, Inmaculada
A1 Velloso-Feijoo, Maria Luisa
A1 Redondo-Rodriguez, Rocio
A1 Jimenez-Nuñez, Francisco Gabriel
A1 Panero Lamothe, Blanca
A1 Padin-Martín, María Isabel
A1 Fernández-Nebro, Antonio
K1 Rheumatoid arthritis
K1 Interstitial lung disease
K1 Biologics
K1 Non-anti-TNF biologics
K1 Antirheumatic drug
K1 Vital capacity
K1 Smoking
K1 Tomography
AB Objectives: To describe a prospective cohort of patients with rheumatoid arthritis associated with interstitial lung disease (RA-ILD) and identify risk factors associated with disease progression and mortality in this cohort. Patients and methods: We performed a multicenter, prospective, observational study of patients with RA-ILD receiving disease-modifying antirheumatic drugs (DMARDs) between 2015 and 2020. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline and at 60 months. The main endpoint was “Progression to ILD at the end of follow-up” in terms of the following outcomes: (1) improvement (i.e., improvement in forced vital capacity (FVC) ≥10% or diffusing capacity of the lungs for carbon monoxide (DLCO) ≥15% and absence of radiological progression); (2) nonprogression (stabilization or improvement in FVC ≤10% or diffusing capacity of the lungs for carbon monoxide (DLCO) <15% and absence of radiological progression); (3) progression (worsening of FVC >10% or DLCO >15% and radiological progression); or (4) death. We recorded demographic and clinical characteristics, lung function, and the incidence of adverse events. A Cox regression analysis was performed to identify factors associated with the worsening of ILD. Results: After 60 months, lung disease had stabilized in 66 patients (56.9%), improved in 9 (7.8%), and worsened in 23 (19.8%). Eighteen patients (15.5%) died, with a mean survival of 71.8 (1.9) months after diagnosis of ILD. The Cox multivariate analysis revealed the independent predictors of worsening of RA-ILD to be usual interstitial pneumonia (hazard ratio (HR), 2.6 (95%CI, 1.0–6.7)), FVC <80% (HR, 3.8 (95%CI, 1.5–6.7)), anticitrullinated protein antibody titers (HR, 2.8 (95%CI, 1.1–6.8)), smoking (HR, 2.5 (95%CI, 1.1–6.2)), and treatment with abatacept, tocilizumab, or rituximab (HR, 0.4 (95%CI, 0.2–0.8)). During follow-up, 79 patients (68%) experienced an adverse event, mostly infection (61%). Infection was fatal in 10/18 patients (55.5%) during follow-up. Conclusions: Lung function is stable in most patients with RA-ILD receiving treatment with disease-modifying anti-rheumatic drugs (DMARDs), although one-third worsened or died. Identifying factors associated with worsening in RA-ILD is important for clinical management.
PB MDPI
YR 2021
FD 2021-02-20
LK http://hdl.handle.net/10668/4143
UL http://hdl.handle.net/10668/4143
LA en
NO Mena-Vázquez N, Rojas-Gimenez M, Romero-Barco CM, Manrique-Arija S, Francisco E, Aguilar-Hurtado MC, et al. Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study. J Clin Med. 2021 Feb 20;10(4):874.
DS RISalud
RD Jul 6, 2025