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
K1 Artritis reumatoide
K1 Enfermedades pulmonares intersticiales
K1 Productos biológicos
K1 Antirreumáticos
K1 Capacidad vital
K1 Fumar
K1 Tomografía
K1 Estudios de cohortes
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 Apr 11, 2025