Rheumatoid arthritis-related interstitial lung disease (RA-ILD): Clinical, functional features, and variables associated poor initial prognosis in a chilean cohort

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Abstract

Introduction: ILD is a frequent extra-articular manifestation of RA and explains for much of the morbidity and mortality. The aims of our study is to describe clinical, functional features of patients with RA-ILD and the variables associated with poor lung function at baseline. Methods: Multicenter retrospective cohort study of patients evaluated in two centers: Instituto Nacional del Torax and Hospital Clinico de la Universidad de Chile. A descriptive and comparative analysis was performed between the RA-ILD and RA/ without ILD groups; and univariate/multivariate analysis for the variables associated with poor lung function (CVF Results: 216 patients with RA: 120 RA-ILD and 96 RA / without ILD were included. 83.8% women with a median age 62 years [50–73]. Patients with RA-ILD were significantly older, more smokers, and showed higher ACPA positivity compared to those RA/ without ILD. The use of methotrexate, leflunomide (LEF), adalimumab and etanercept; was significantly lower in RA-ILD. In 90.5% the diagnosis of ILD was made in the context of an established disease. In 47.5% the patients were poor lung function baseline of these 52.6% had UIP pattern. The variables associated with poor pulmonary function were smoking (OR 9.23, p=0.012), longer duration of arthritis (OR 0.79, p=0.007) and use of LEF (OR 0.13, p=0.066). Conclusions: In our cohort, the diagnosis of ILD was made in the context of an established disease, presenting the majority radiological pattern of UIP. The factors associated with poor lung function forced smoking and the duration of RA and the use of LEF stand out as a protective factor.