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Rheumatoid arthritis-related interstitial lung disease (RA-ILD): a possible association between disease activity and prognosis

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Abstract

Objectives

We hypothesized that RA disease activity might be associated with the survival of RA-ILD patients. To evaluate this possibility, we analyzed data on disease activity during follow-up in an RA-ILD cohort and compared disease activity between surviving patients and those who died during follow-up.

Methods

RA-ILD patients referred for medical evaluation and treatment at a single center, with CDAI scores during all follow up were included. We estimated the HR of the mean of the CDAI score during follow-up with survival. Also, we compared the survival function of patients with high disease activity (CDAI scores ≥ 22) during all follow-up with those with moderate and low disease activity.

Results

Thirty-seven patients were included. The mean of the CDAI score during follow-up was higher in death patients (median 30.8 ± 18.5 Vs. 16.8 ± 11.3), and a single unit increase in the mean of the CDAI score was associated with non-survival, HR:1.07 (95% CI: 1.02 -1.12). Patients with high disease activity during all follow-up (CDAI scores > 22) had lower survival function in comparison with moderate and low disease activity (P = 0.042).

Conclusion

The results of the study suggest that higher RA disease activity is associated with a worse prognosis of RA-ILD patients. The hypothesis that high disease activity is associated with worse survival in RA-ILD patients must be evaluated in more extensive cohort studies and clinical trials.

Key Points:

• RA-ILD patients with high disease activity during follow-up had a worse prognosis than those with moderate or low disease activity.

• The study results suggest the hypothesis that patients with RA-ILD must be treated with a treat to target strategy, with the aim of remission or low RA disease activity.

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Authors and Affiliations

  1. Interstitial Lung Disease and Rheumatology Unit, DF. Tlalpan, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, Calzada de Tlalpan 4502, Sección XVI, México, México, CP, 14080

    Jorge Rojas-Serrano, Mayra Mejía, Pedro A. Rivera-Matias, Denisse Herrera-Bringas, Diana I. Pérez-Román, Renzo Pérez-Dorame & Heidegger Mateos-Toledo

  2. Programa de Maestría y Doctorado en Ciencias Médicas, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacán, Mexico

    Jorge Rojas-Serrano

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  1. Jorge Rojas-Serrano
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Correspondence to Jorge Rojas-Serrano.

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Rojas-Serrano, J., Mejía, M., Rivera-Matias, P.A. et al. Rheumatoid arthritis-related interstitial lung disease (RA-ILD): a possible association between disease activity and prognosis. Clin Rheumatol 41, 1741–1747 (2022). https://doi.org/10.1007/s10067-021-06040-8

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