Lung function trajectory of rheumatoid arthritis-associated interstitial lung disease.

To explore the course of lung function and RA disease activity and predictive factors for deteriorating lung function in patients with RA-interstitial lung disease (ILD). The Korean Rheumatoid Arthritis-Interstitial Lung Disease cohort is a multicentre, prospective observational cohort. Patients with RA-ILD were enrolled and followed up annually for 3 years for RA disease activity and ILD status assessment. Group-based modelling was used to cluster a similar predicted percentage of forced vital capacity (FVC%) patterns into trajectories. This study included 140 patients who underwent at least two pulmonary function tests. Four distinctive trajectories for predicted FVC% were 'improving' [n = 11 (7.9%)], 'stable' [n = 68 (38.4%)], 'slowly declining' [n = 54 (48.6%)] and 'rapidly declining' [n = 7 (5.0%)]. Most (77.7%) patients maintained or improved to low RA disease activity. The lung function trajectory was not comparable to the RA disease activity trajectory. Age ≥70 years [relative risk (RR) 10.8 (95% CI 1.30, 89.71)] and early RA diagnosed within the preceding 2 years [RR 10.1 (95% CI 1.22, 84.2)] were associated with increased risk for rapidly declining predicted FVC%. The risk for deterioration or mortality increased in patients with a simultaneous diagnosis of RA and ILD within 24 weeks [RR 9.18 (95% CI 2.05, 41.0)] and the extent of lung involvement [RR 3.28 (95% CI 1.12, 9.60)]. Most patients with RA-ILD experienced stable or slowly declining lung function. In 5% of patients, predicted FVC% deteriorated rapidly, especially in older adults with early RA. The lung function trajectory was not comparable to the RA disease activity trajectory. © The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Citation

Sung Hae Chang, Ji Sung Lee, You-Jung Ha, Min Uk Kim, Chan Ho Park, Jeong Seok Lee, Ji-Won Kim, Sang Wan Chung, Jung Yoon Pyo, Sung Won Lee, Eun Ha Kang, Yeon-Ah Lee, Yong-Beom Park, Jung-Yoon Choe, Eun Young Lee. Lung function trajectory of rheumatoid arthritis-associated interstitial lung disease. Rheumatology (Oxford, England). 2023 Sep 01;62(9):3014-3024

Mesh Tags

PMID: 36702465

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