Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis : A Multicentre Italian Study

BACKGROUND: The INBUILD study demonstrated the efficacy of nintedanib in the treatment of progressive fibrosing interstitial lung disease different to idiopathic pulmonary fibrosis, including rheumatoid arthritis (RA)-related ILD. Nevertheless, the prevalence of RA-ILD patients that may potentially benefit from nintedanib remains unknown.

OBJECTIVES AND METHODS: The aim of the present multicentre study was to investigate the prevalence and possible associated factors of fibrosing progressive patterns in a cross-sectional cohort of RA-ILD patients.

RESULTS: One hundred and thirty-four RA-ILD patients with a diagnosis of RA-ILD, who were confirmed at high-resolution computed tomography and with a follow-up of at least 24 months, were enrolled. The patients were defined as having a progressive fibrosing ILD in case of a relative decline in forced vital capacity > 10% predicted and/or an increased extent of fibrotic changes on chest imaging in a 24-month period. Respiratory symptoms were excluded to reduce possible bias due to the retrospective interpretation of cough and dyspnea. According to radiologic features, ILD was classified as usual interstitial pneumonia (UIP) in 50.7% of patients, nonspecific interstitial pneumonia in 19.4%, and other patterns in 29.8%. Globally, a fibrosing progressive pattern was recorded in 36.6% of patients (48.5% of patients with a fibrosing pattern) with a significant association to the UIP pattern.

CONCLUSION: We observed that more than a third of RA-ILD patients showed a fibrosing progressive pattern and might benefit from antifibrotic treatment. This study shows some limitations, such as the retrospective design. The exclusion of respiratory symptoms' evaluation might underestimate the prevalence of progressive lung disease but increases the value of results.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:12

Enthalten in:

Journal of clinical medicine - 12(2023), 22 vom: 11. Nov.

Sprache:

Englisch

Beteiligte Personen:

Sebastiani, Marco [VerfasserIn]
Venerito, Vincenzo [VerfasserIn]
Laurino, Elenia [VerfasserIn]
Gentileschi, Stefano [VerfasserIn]
Atzeni, Fabiola [VerfasserIn]
Canofari, Claudia [VerfasserIn]
Andrisani, Dario [VerfasserIn]
Cassone, Giulia [VerfasserIn]
Lavista, Marlea [VerfasserIn]
D'Alessandro, Francesco [VerfasserIn]
Vacchi, Caterina [VerfasserIn]
Scardapane, Arnaldo [VerfasserIn]
Frediani, Bruno [VerfasserIn]
Cazzato, Massimiliano [VerfasserIn]
Salvarani, Carlo [VerfasserIn]
Iannone, Florenzo [VerfasserIn]
Manfredi, Andreina [VerfasserIn]

Links:

Volltext

Themen:

High-resolution computed tomography
Interstitial lung disease (ILD)
Journal Article
Nintedanib
Progressive fibrosing ILD
Rheumatoid arthritis

Anmerkungen:

Date Revised 27.11.2023

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.3390/jcm12227041

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM364938730