Skip to main content

Advertisement

SpringerLink
Log in

Rheumatoid Arthritis-Associated Interstitial Lung Disease: Current Concepts

  • Rheumatoid Arthritis (L Moreland, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Among the many extra-articular complications of rheumatoid arthritis (RA), interstitial lung disease (ILD) contributes significantly to morbidity and mortality. Prevalence estimates for RA-ILD vary widely depending on the specific clinical, radiographic, and functional criteria used to establish the diagnosis. A key unresolved issue is whether early, subclinical forms of RA-ILD represent a precursor to end stage, fibrotic lung disease. Based on uncertainties surrounding the natural history of RA-ILD, incomplete understanding of underlying disease pathogenesis, and lack of controlled clinical trials, evidence-based therapeutic strategies remain largely undefined.

Recent Findings

Correlative clinico-epidemiological studies have identified key risk factors for disease progression. Complementing these findings, the identification of specific molecular and serological markers of RA-ILD has improved our understanding of disease pathogenesis and established the foundation for predictive biomarker profiling. Experience from case series and cohort studies suggests that newer biological agents such as rituximab may be viable treatment options.

Summary

RA-ILD continues to have a major impact on “disease intrinsic” morbidity and mortality. Increased understanding of disease pathogenesis and the natural history of subclinical RA-ILD will promote the development of more refined therapeutic strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet. 2010;376(9746):1094–108. https://doi.org/10.1016/S0140-6736(10)60826-4.

    Article  PubMed  Google Scholar 

  2. Shaw M, Collins BF, Ho LA, Raghu G. Rheumatoid arthritis-associated lung disease. Eur Respir Rev. 2015;24(135):1–16. https://doi.org/10.1183/09059180.00008014.

    Article  PubMed  Google Scholar 

  3. Turesson C, O'Fallon WM, Crowson CS, Gabriel SE, Matteson EL. Extra-articular disease manifestations in rheumatoid arthritis: incidence trends and risk factors over 46 years. Ann Rheum Dis. 2003;62(8):722–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Suda T. Up-to-date information on rheumatoid arthritis-associated interstitial lung disease. Clin Med Insights Circ Respir Pulm Med. 2015;9(Suppl 1):155–62. https://doi.org/10.4137/CCRPM.S23289.

    PubMed  Google Scholar 

  5. Brown KK. Rheumatoid lung disease. Proc Am Thorac Soc. 2007;4(5):443–8. https://doi.org/10.1513/pats.200703-045MS.

    Article  PubMed  PubMed Central  Google Scholar 

  6. • Gochuico BR, Avila NA, Chow CK, Novero LJ, Wu HP, Ren P, et al. Progressive preclinical interstitial lung disease in rheumatoid arthritis. Arch Intern Med. 2008;168(2):159–66. https://doi.org/10.1001/archinternmed.2007.59. Through the use of multiplex ELISA-based technology, this study examined the relationship between levels of various cytokines/chemokines in bronchoalveolar lavage fluid and subtype of RA-ILD, demonstrating that specific cytokine profiles predict radiographic progression in “subclinical” RA-ILD.

    Article  CAS  PubMed  Google Scholar 

  7. Metafratzi ZM, Georgiadis AN, Ioannidou CV, Alamanos Y, Vassiliou MP, Zikou AK, et al. Pulmonary involvement in patients with early rheumatoid arthritis. Scand J Rheumatol. 2007;36(5):338–44. https://doi.org/10.1080/03009740701393957.

    Article  CAS  PubMed  Google Scholar 

  8. Young A, Koduri G, Batley M, Kulinskaya E, Gough A, Norton S, et al. Mortality in rheumatoid arthritis. Increased in the early course of disease, in ischaemic heart disease and in pulmonary fibrosis. Rheumatology (Oxford). 2007;46(2):350–7. https://doi.org/10.1093/rheumatology/kel253.

    Article  CAS  Google Scholar 

  9. Ayhan-Ardic FF, Oken O, Yorgancioglu ZR, Ustun N, Gokharman FD. Pulmonary involvement in lifelong non-smoking patients with rheumatoid arthritis and ankylosing spondylitis without respiratory symptoms. Clin Rheumatol. 2006;25(2):213–8. https://doi.org/10.1007/s10067-005-1158-x.

    Article  PubMed  Google Scholar 

  10. Cortet B, Flipo RM, Remy-Jardin M, Coquerelle P, Duquesnoy B, Remy J, et al. Use of high resolution computed tomography of the lungs in patients with rheumatoid arthritis. Ann Rheum Dis. 1995;54(10):815–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Demir R, Bodur H, Tokoglu F, Olcay I, Ucan H, Borman P. High resolution computed tomography of the lungs in patients with rheumatoid arthritis. Rheumatol Int. 1999;19(1–2):19–22.

    Article  CAS  PubMed  Google Scholar 

  12. Gabbay E, Tarala R, Will R, Carroll G, Adler B, Cameron D, et al. Interstitial lung disease in recent onset rheumatoid arthritis. Am J Respir Crit Care Med. 1997;156(2 Pt 1):528–35. https://doi.org/10.1164/ajrccm.156.2.9609016.

    Article  CAS  PubMed  Google Scholar 

  13. Georgiadis AN, Metafratzi ZM, Drosos AA. Pulmonary abnormalities in patients with early and longstanding rheumatoid arthritis. J Rheumatol. 2009;36(2):444–445; author reply 5-6. https://doi.org/10.3899/jrheum.080882.

    Article  PubMed  Google Scholar 

  14. Kelly C, Saravanan V. Treatment strategies for a rheumatoid arthritis patient with interstitial lung disease. Expert Opin Pharmacother. 2008;9(18):3221–30. https://doi.org/10.1517/14656560802591430.

    Article  CAS  PubMed  Google Scholar 

  15. •• Kim EJ, Elicker BM, Maldonado F, Webb WR, Ryu JH, Van Uden JH, et al. Usual interstitial pneumonia in rheumatoid arthritis-associated interstitial lung disease. Eur Respir J. 2010;35(6):1322–8. https://doi.org/10.1183/09031936.00092309. This study suggests that RA-UIP (as assessed by HRCT) carries an extremely poor prognosis paralleling that of IPF.

    Article  CAS  PubMed  Google Scholar 

  16. Mori S, Cho I, Koga Y, Sugimoto M. Comparison of pulmonary abnormalities on high-resolution computed tomography in patients with early versus longstanding rheumatoid arthritis. J Rheumatol. 2008;35(8):1513–21.

    PubMed  Google Scholar 

  17. Tanaka N, Kim JS, Newell JD, Brown KK, Cool CD, Meehan R, et al. Rheumatoid arthritis-related lung diseases: CT findings. Radiology. 2004;232(1):81–91. https://doi.org/10.1148/radiol.23210301742321030174.

    Article  PubMed  Google Scholar 

  18. Olson AL, Swigris JJ, Sprunger DB, Fischer A, Fernandez-Perez ER, Solomon J, et al. Rheumatoid arthritis-interstitial lung disease-associated mortality. Am J Respir Crit Care Med. 2011;183(3):372–8. https://doi.org/10.1164/rccm.201004-0622OC.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Koduri G, Norton S, Young A, Cox N, Davies P, Devlin J, et al. Interstitial lung disease has a poor prognosis in rheumatoid arthritis: results from an inception cohort. Rheumatology (Oxford). https://doi.org/10.1093/rheumatology/keq035.

  20. Bongartz T, Nannini C, Medina-Velasquez YF, Achenbach SJ, Crowson CS, Ryu JH, et al. Incidence and mortality of interstitial lung disease in rheumatoid arthritis: a population-based study. Arthritis Rheum. 2010;62(6):1583–91. https://doi.org/10.1002/art.27405.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hyldgaard C, Hilberg O, Pedersen AB, Ulrichsen SP, Lokke A, Bendstrup E, et al. A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: comorbidity and mortality. Ann Rheum Dis. 2017;76(10):1700–6. https://doi.org/10.1136/annrheumdis-2017-211138.

    Article  PubMed  Google Scholar 

  22. Antoniou KM, Margaritopoulos G, Economidou F, Siafakas NM. Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement. Eur Respir J. 2009;33(4):882–96. https://doi.org/10.1183/09031936.00152607.

    Article  CAS  PubMed  Google Scholar 

  23. Dawson JK, Fewins HE, Desmond J, Lynch MP, Graham DR. Predictors of progression of HRCT diagnosed fibrosing alveolitis in patients with rheumatoid arthritis. Ann Rheum Dis. 2002;61(6):517–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Naz SM, Symmons DP. Mortality in established rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2007;21(5):871–83. https://doi.org/10.1016/j.berh.2007.05.003.

    Article  PubMed  Google Scholar 

  25. Flaherty KR, Mumford JA, Murray S, Kazerooni EA, Gross BH, Colby TV, et al. Prognostic implications of physiologic and radiographic changes in idiopathic interstitial pneumonia. Am J Respir Crit Care Med. 2003;168(5):543–8. https://doi.org/10.1164/rccm.200209-1112OC200209-1112OC.

    Article  PubMed  Google Scholar 

  26. Hunninghake GW, Zimmerman MB, Schwartz DA, King TE Jr, Lynch J, Hegele R, et al. Utility of a lung biopsy for the diagnosis of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2001;164(2):193–6. https://doi.org/10.1164/ajrccm.164.2.2101090.

    Article  CAS  PubMed  Google Scholar 

  27. • Kim EJ, Collard HR, King TE Jr. Rheumatoid arthritis-associated interstitial lung disease: the relevance of histopathologic and radiographic pattern. Chest. 2009;136(5):1397–405. https://doi.org/10.1378/chest.09-0444. This commentary summarizes other studies showing a close correlation between HRCT pattern and UIP histopathology as well as reduced survival in RA-UIP.

    Article  PubMed  PubMed Central  Google Scholar 

  28. O'Dwyer DN, Armstrong ME, Cooke G, Dodd JD, Veale DJ, Donnelly SC. Rheumatoid arthritis (RA) associated interstitial lung disease (ILD). Eur J Intern Med. 2013;24(7):597–603. https://doi.org/10.1016/j.ejim.2013.07.004.

    Article  PubMed  Google Scholar 

  29. Leslie KO, Trahan S, Gruden J. Pulmonary pathology of the rheumatic diseases. Semin Respir Crit Care Med. 2007;28(4):369–78. https://doi.org/10.1055/s-2007-985609.

    Article  PubMed  Google Scholar 

  30. Paulin F, Doyle TJ, Fletcher EA, Ascherman DP, Rosas IO. Rheumatoid arthritis-associated interstitial lung disease and idiopathic pulmonary fibrosis: shared mechanistic and phenotypic traits suggest overlapping disease mechanisms. Rev Investig Clin. 2015;67(5):280–6.

    Google Scholar 

  31. Rajasekaran A, Shovlin D, Saravanan V, Lord P, Kelly C. Interstitial lung disease in patients with rheumatoid arthritis: comparison with cryptogenic fibrosing alveolitis over 5 years. J Rheumatol. 2006;33(7):1250–3.

    PubMed  Google Scholar 

  32. Park JH, Kim DS, Park IN, Jang SJ, Kitaichi M, Nicholson AG, et al. Prognosis of fibrotic interstitial pneumonia: idiopathic versus collagen vascular disease-related subtypes. Am J Respir Crit Care Med. 2007;175(7):705–11. https://doi.org/10.1164/rccm.200607-912OC.

    Article  PubMed  Google Scholar 

  33. Nurmi HM, Purokivi MK, Karkkainen MS, Kettunen HP, Selander TA, Kaarteenaho RL. Variable course of disease of rheumatoid arthritis-associated usual interstitial pneumonia compared to other subtypes. BMC Pulm Med. 2016;16(1):107. https://doi.org/10.1186/s12890-016-0269-2.

    Article  PubMed  PubMed Central  Google Scholar 

  34. • Yunt ZX, Chung JH, Hobbs S, Fernandez-Perez ER, Olson AL, Huie TJ, et al. High resolution computed tomography pattern of usual interstitial pneumonia in rheumatoid arthritis-associated interstitial lung disease: Relationship to survival. Respir Med. 2017;126:100–4. https://doi.org/10.1016/j.rmed.2017.03.027. This study of 158 RA-ILD patients demonstrates that individuals with HRCT patterns of definite/probable UIP have significantly reduced survival compared to patients with non-UIP radiographic abnormalities.

    Article  PubMed  Google Scholar 

  35. Solomon JJ, Chung JH, Cosgrove GP, Demoruelle MK, Fernandez-Perez ER, Fischer A, et al. Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease. Eur Respir J. 2016;47(2):588–96. https://doi.org/10.1183/13993003.00357-2015.

    Article  PubMed  Google Scholar 

  36. Zamora-Legoff JA, Krause ML, Crowson CS, Ryu JH, Matteson EL. Patterns of interstitial lung disease and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2017;56(3):344–50. https://doi.org/10.1093/rheumatology/kew391.

    Google Scholar 

  37. • Morisset J, Vittinghoff E, Lee BY, Tonelli R, Hu X, Elicker BM, et al. The performance of the GAP model in patients with rheumatoid arthritis associated interstitial lung disease. Respir Med. 2017;127:51–6. https://doi.org/10.1016/j.rmed.2017.04.012. In this study, the authors demonstrate that the GAP (Gender, Age, Physiology) model (previously validated in IPF) performs extremely well as a predictor of survival in RA-ILD—suggesting that physiology/functional parameters may be more important than underlying histopathology in determining clinical outcome.

    Article  PubMed  Google Scholar 

  38. Agostini C, Gurrieri C. Chemokine/cytokine cocktail in idiopathic pulmonary fibrosis. Proc Am Thorac Soc. 2006;3(4):357–63. https://doi.org/10.1513/pats.200601-010TK.

    Article  CAS  PubMed  Google Scholar 

  39. Pardo A, Gibson K, Cisneros J, Richards TJ, Yang Y, Becerril C, et al. Up-regulation and profibrotic role of osteopontin in human idiopathic pulmonary fibrosis. PLoS Med. 2005;2(9):e251. https://doi.org/10.1371/journal.pmed.0020251.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Rao RN, Goodman LR, Tomashefski JF Jr. Smoking-related interstitial lung disease. Ann Diagn Pathol. 2008;12(6):445–57. https://doi.org/10.1016/j.anndiagpath.2008.10.001.

    Article  PubMed  Google Scholar 

  41. Saag KG, Kolluri S, Koehnke RK, Georgou TA, Rachow JW, Hunninghake GW, et al. Rheumatoid arthritis lung disease. Determinants of radiographic and physiologic abnormalities. Arthritis Rheum. 1996;39(10):1711–9.

    Article  CAS  PubMed  Google Scholar 

  42. Thorley AJ, Tetley TD. Pulmonary epithelium, cigarette smoke, and chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2007;2(4):409–28.

    CAS  PubMed  PubMed Central  Google Scholar 

  43. Wilson MS, Wynn TA. Pulmonary fibrosis: pathogenesis, etiology and regulation. Mucosal Immunol. 2009;2(2):103–21. https://doi.org/10.1038/mi.2008.85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Yang Q, Underwood MJ, Hsin MK, Liu XC, He GW. Dysfunction of pulmonary vascular endothelium in chronic obstructive pulmonary disease: basic considerations for future drug development. Curr Drug Metab. 2008;9(7):661–7.

    Article  CAS  PubMed  Google Scholar 

  45. Shimizu S, Yoshinouchi T, Niimi T, Ohtsuki Y, Fujita J, Maeda H, et al. Differing distributions of CXCR3- and CCR4-positive cells among types of interstitial pneumonia associated with collagen vascular diseases. Virchows Arch. 2007;450(1):51–8. https://doi.org/10.1007/s00428-006-0330-2.

    Article  CAS  PubMed  Google Scholar 

  46. • Willis VC, Demoruelle MK, Derber LA, Chartier-Logan CJ, Parish MC, Pedraza IF, et al. Sputum autoantibodies in patients with established rheumatoid arthritis and subjects at risk of future clinically apparent disease. Arthritis Rheum. 2013;65(10):2545–54. https://doi.org/10.1002/art.38066. By showing that sputum autoantibodies (RF, CCP) often predate the development of serum autoantibodies in preclinical RA, this analysis provides evidence that the lung (rather than the joints) may represent the site in which immune tolerance toward relevant RA autoantigens is breached.

    CAS  PubMed  PubMed Central  Google Scholar 

  47. Reynisdottir G, Karimi R, Joshua V, Olsen H, Hensvold AH, Harju A, et al. Structural changes and antibody enrichment in the lungs are early features of anti-citrullinated protein antibody-positive rheumatoid arthritis. Arthritis Rheum. 2014;66(1):31–9. https://doi.org/10.1002/art.38201.

    Article  CAS  Google Scholar 

  48. • Harlow L, Gochuico BR, Rosas IO, Doyle TJ, Osorio JC, Travers TS, et al. Anti-citrullinated heat shock protein 90 antibodies identified in bronchoalveolar lavage fluid are a marker of lung-specific immune responses. Clin Immunol. 2014;155(1):60–70. https://doi.org/10.1016/j.clim.2014.08.004. Through comparative epitope profiling of anti-citrullinated HSP90 protein/peptide autoantibodies in bronchoalveolar lavage fluid and serum, this study demonstrates both qualitative and quantitative differences in epitope recognition between these tissue compartments—providing direct evidence that the lung plays an important role in initiating and/or shaping the repertoire of antigen-specific B cell responses in RA.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Giles JT, Darrah E, Danoff S, Johnson C, Andrade F, Rosen A, et al. Association of cross-reactive antibodies targeting peptidyl-arginine deiminase 3 and 4 with rheumatoid arthritis-associated interstitial lung disease. PLoS One. 2014;9(6):e98794. https://doi.org/10.1371/journal.pone.0098794.

    Article  PubMed  PubMed Central  Google Scholar 

  50. England BR, Thiele GM, Duryee MJ, et al. Associations of serum anti-malondialdehyde-acetaldehyde (MAA) antibodies with cardiovascular and respiratory mortality in men with rheumatoid arthritis. Arthritis Rheum. 2015;67(S10) http://acrabstract.org/abstract/associations-of-serum-anti-malondialdehyde-acetaldehyde-maa-anibodies-with-cardiovascular-and-respiratory-mortality-in-men-with-rheumatoid-arthritis/

  51. Smadja DM, Nunes H, Juvin K, Bertil S, Valeyre D, Gaussem P, et al. Increase in both angiogenic and angiostatic mediators in patients with idiopathic pulmonary fibrosis. Pathol Biol (Paris). 2014;62(6):391–4. https://doi.org/10.1016/j.patbio.2014.07.006.

    Article  CAS  Google Scholar 

  52. Rosenbloom J, Mendoza FA, Jimenez SA. Strategies for anti-fibrotic therapies. Biochim Biophys Acta. 2013;1832(7):1088–103. https://doi.org/10.1016/j.bbadis.2012.12.007.

    Article  CAS  PubMed  Google Scholar 

  53. •• Chen J, Doyle TJ, Liu Y, Aggarwal R, Wang X, Shi Y, et al. Biomarkers of rheumatoid arthritis-associated interstitial lung disease. Arthritis Rheum. 2015;67(1):28–38. https://doi.org/10.1002/art.38904. This study demonstrated an association between RA-ILD and elevated serum levels of MMP-7 as well as IP10 in two independent cohorts of RA patients with varying stages of ILD.

    Article  CAS  Google Scholar 

  54. • Doyle TJ, Patel AS, Hatabu H, Nishino M, Wu G, Osorio JC, et al. Detection of rheumatoid arthritis-interstitial lung disease is enhanced by serum biomarkers. Am J Respir Crit Care Med. 2015;191(12):1403–12. https://doi.org/10.1164/rccm.201411-1950OC. In this study, the authors demonstrate that combining specified clinical/serological parameters with levels of designated serum biomarkers (MMP-7, PARC, SP-D) yields a powerful tool for identification of both subclinical and clinically evident RA-ILD.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Wang T, Zheng XJ, Ji YL, Liang ZA, Liang BM. Tumour markers in rheumatoid arthritis-associated interstitial lung disease. Clin Exp Rheumatol. 2016;34(4):587–91.

    CAS  PubMed  Google Scholar 

  56. Giles JT, Danoff SK, Sokolove J, Wagner CA, Winchester R, Pappas DA, et al. Association of fine specificity and repertoire expansion of anticitrullinated peptide antibodies with rheumatoid arthritis associated interstitial lung disease. Ann Rheum Dis. 2014;73(8):1487–94. https://doi.org/10.1136/annrheumdis-2012-203160.

    Article  CAS  PubMed  Google Scholar 

  57. •• Harlow L, Rosas IO, Gochuico BR, Mikuls TR, Dellaripa PF, Oddis CV, et al. Identification of citrullinated hsp90 isoforms as novel autoantigens in rheumatoid arthritis-associated interstitial lung disease. Arthritis Rheum. 2013;65(4):869–79. https://doi.org/10.1002/art.37881. Using a novel reverse immunophenotyping method, the authors identify antibodies targeting citrullinated isoforms of HSP90 as moderately sensitive, but highly specific, markers of RA-ILD.

    Article  CAS  PubMed  Google Scholar 

  58. Song ST, Kim SS, Kim JY, Lee SY, Kim K, Kwon IS, et al. Association of single nucleotide polymorphisms of PADI4 and HLA-DRB1 alleles with susceptibility to rheumatoid arthritis-related lung diseases. Lung. 2016;194(5):745–53. https://doi.org/10.1007/s00408-016-9916-x.

    Article  CAS  PubMed  Google Scholar 

  59. Oka S, Furukawa H, Shimada K, Hashimoto A, Komiya A, Fukui N, et al. Plasma miRNA expression profiles in rheumatoid arthritis associated interstitial lung disease. BMC Musculoskelet Disord. 2017;18(1):21. https://doi.org/10.1186/s12891-017-1389-4.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Vij R, Strek ME. Diagnosis and treatment of connective tissue disease-associated interstitial lung disease. Chest. 2013;143(3):814–24. https://doi.org/10.1378/chest.12-0741.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. • Md Yusof MY, Kabia A, Darby M, Lettieri G, Beirne P, Vital EM, et al. Effect of rituximab on the progression of rheumatoid arthritis-related interstitial lung disease: 10 years’ experience at a single centre. Rheumatology (Oxford). 2017;56(8):1348–57. https://doi.org/10.1093/rheumatology/kex072. This retrospective analysis of 700 RA patients (56 with known RA-ILD) treated with rituximab suggests that this biologic agent may be effective in stabilizing and/or improving co-existing ILD.

    Article  Google Scholar 

  62. Roubille C, Haraoui B. Interstitial lung diseases induced or exacerbated by DMARDS and biologic agents in rheumatoid arthritis: a systematic literature review. Semin Arthritis Rheum. 2014;43(5):613–26. https://doi.org/10.1016/j.semarthrit.2013.09.005.

    Article  CAS  PubMed  Google Scholar 

  63. Perez-Alvarez R, Perez-de-Lis M, Diaz-Lagares C, Pego-Reigosa JM, Retamozo S, Bove A, et al. Interstitial lung disease induced or exacerbated by TNF-targeted therapies: analysis of 122 cases. Semin Arthritis Rheum. 2011;41(2):256–64. https://doi.org/10.1016/j.semarthrit.2010.11.002.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, University of Miami Miller School of Medicine, Miami, FL, USA

    Yoel Brito & Marilyn K. Glassberg

  2. Division of Rheumatology, University of Miami Miller School of Medicine, Rosenstiel Medical Science Building, 7152, 1600 NW 10th Avenue, Miami, FL, 33136-1050, USA

    Dana P. Ascherman

Authors
  1. Yoel Brito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marilyn K. Glassberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dana P. Ascherman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dana P. Ascherman.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Rheumatoid Arthritis

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Brito, Y., Glassberg, M.K. & Ascherman, D.P. Rheumatoid Arthritis-Associated Interstitial Lung Disease: Current Concepts. Curr Rheumatol Rep 19, 79 (2017). https://doi.org/10.1007/s11926-017-0701-5

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11926-017-0701-5

Keywords

Search

Navigation