Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid Arthritis

Interstitial lung disease (ILD) is a frequent manifestation of rheumatoid arthritis (RA) that is associated with high mortality. RA‐ILD may initially be asymptomatic, and lung function may be markedly impaired by the time it is diagnosed. The course of RA‐ILD is highly variable, with some patients e...

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Main Authors: Eric L. Matteson, Elisabeth Bendstrup, Mary E. Strek, Philippe Dieudé
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.11736
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author Eric L. Matteson
Elisabeth Bendstrup
Mary E. Strek
Philippe Dieudé
author_facet Eric L. Matteson
Elisabeth Bendstrup
Mary E. Strek
Philippe Dieudé
author_sort Eric L. Matteson
collection DOAJ
description Interstitial lung disease (ILD) is a frequent manifestation of rheumatoid arthritis (RA) that is associated with high mortality. RA‐ILD may initially be asymptomatic, and lung function may be markedly impaired by the time it is diagnosed. The course of RA‐ILD is highly variable, with some patients experiencing no discernable progression or a slow decline, whereas others experience more rapid deterioration. Some patients develop progressive pulmonary fibrosis, which is associated with high mortality. Although risk factors for the progression of RA‐ILD have been identified, including older age, worse lung function, and a usual interstitial pneumonia pattern on high‐resolution computed tomography, it is not possible to predict the course of RA‐ILD in an individual patient. The association between RA disease activity and progression of RA‐ILD remains unclear. Regular monitoring is important to enable the prompt identification of progression and early intervention to preserve lung function. The management of RA‐ILD requires a multidisciplinary and individualized approach, taking account of the severity and progression of articular and lung disease, risk factors for the progression of RA‐ILD, and the patient's preferences, and may include immunosuppression, antifibrotic therapy, and supportive care.
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spelling doaj-art-2ea978f14faf45d781df2fe27446ede02025-08-20T02:49:52ZengWileyACR Open Rheumatology2578-57452024-12-0161283684510.1002/acr2.11736Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid ArthritisEric L. Matteson0Elisabeth Bendstrup1Mary E. Strek2Philippe Dieudé3Mayo Clinic College of Medicine and Science Rochester MinnesotaAarhus University Hospital and Aarhus University Aarhus DenmarkUniversity of Chicago Chicago IllinoisAssistance Publique‐Hôpitaux de Paris Cité, Bichat‐Claude Bernard University Hospital, INSERM UMR1152, University of Paris Paris FranceInterstitial lung disease (ILD) is a frequent manifestation of rheumatoid arthritis (RA) that is associated with high mortality. RA‐ILD may initially be asymptomatic, and lung function may be markedly impaired by the time it is diagnosed. The course of RA‐ILD is highly variable, with some patients experiencing no discernable progression or a slow decline, whereas others experience more rapid deterioration. Some patients develop progressive pulmonary fibrosis, which is associated with high mortality. Although risk factors for the progression of RA‐ILD have been identified, including older age, worse lung function, and a usual interstitial pneumonia pattern on high‐resolution computed tomography, it is not possible to predict the course of RA‐ILD in an individual patient. The association between RA disease activity and progression of RA‐ILD remains unclear. Regular monitoring is important to enable the prompt identification of progression and early intervention to preserve lung function. The management of RA‐ILD requires a multidisciplinary and individualized approach, taking account of the severity and progression of articular and lung disease, risk factors for the progression of RA‐ILD, and the patient's preferences, and may include immunosuppression, antifibrotic therapy, and supportive care.https://doi.org/10.1002/acr2.11736
spellingShingle Eric L. Matteson
Elisabeth Bendstrup
Mary E. Strek
Philippe Dieudé
Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid Arthritis
ACR Open Rheumatology
title Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid Arthritis
title_full Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid Arthritis
title_fullStr Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid Arthritis
title_full_unstemmed Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid Arthritis
title_short Clinical Course of Interstitial Lung Disease in Patients With Rheumatoid Arthritis
title_sort clinical course of interstitial lung disease in patients with rheumatoid arthritis
url https://doi.org/10.1002/acr2.11736
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