Cheilonda Johnson1. 1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Abstract
PURPOSE OF REVIEW: To provide an overview of recently published articles covering interstitial lung disease associated with rheumatoid arthritis (RA-ILD). RECENT FINDINGS: Over the past year, many studies replicated previous findings in more diverse and occasionally larger populations internationally. Specifically, the association among cigarette smoking, high rheumatoid factor titer, elevated anticitrullinated protein antibody (ACPA) levels, and RA-ILD was strengthened. Clinical characteristics, autoantibodies, and biomarkers to aid in RA-ILD development, progression, and mortality prediction were explored. Finally, direct and indirect treatment effects were highlighted. SUMMARY: The ability to identify risk factors for preclinical RA-ILD has been enhanced, but the proper management strategy for these patients is yet to be defined. ACPAs and cigarette smoking are highly associated with RA-ILD, but the mechanistic relationship between lung injury and autoantibody generation remains unknown. There is conflicting evidence regarding the significance of a usual interstitial pneumonia (UIP) versus non-UIP pattern on high-resolution computed tomography. The use of biologic agents in patients with rheumatoid arthritis does not appear to increase the risk of incident ILD or RA-ILD exacerbation. Randomized prospective studies of specific therapy for RA-ILD are still lacking.
PURPOSE OF REVIEW: To provide an overview of recently published articles covering interstitial lung disease associated with rheumatoid arthritis (RA-ILD). RECENT FINDINGS: Over the past year, many studies replicated previous findings in more diverse and occasionally larger populations internationally. Specifically, the association among cigarette smoking, high rheumatoid factor titer, elevated anticitrullinated protein antibody (ACPA) levels, and RA-ILD was strengthened. Clinical characteristics, autoantibodies, and biomarkers to aid in RA-ILD development, progression, and mortality prediction were explored. Finally, direct and indirect treatment effects were highlighted. SUMMARY: The ability to identify risk factors for preclinical RA-ILD has been enhanced, but the proper management strategy for these patients is yet to be defined. ACPAs and cigarette smoking are highly associated with RA-ILD, but the mechanistic relationship between lung injury and autoantibody generation remains unknown. There is conflicting evidence regarding the significance of a usual interstitial pneumonia (UIP) versus non-UIP pattern on high-resolution computed tomography. The use of biologic agents in patients with rheumatoid arthritis does not appear to increase the risk of incident ILD or RA-ILD exacerbation. Randomized prospective studies of specific therapy for RA-ILD are still lacking.
Authors: Emily K Wu; Robert D Ambrosini; R Matthew Kottmann; Christopher T Ritchlin; Edward M Schwarz; Homaira Rahimi Journal: Curr Rheumatol Rev Date: 2019
Authors: Jeffrey A Sparks; Xintong He; Jie Huang; Elaine A Fletcher; Alessandra Zaccardelli; H Maura Friedlander; Ritu R Gill; Hiroto Hatabu; Mizuki Nishino; David J Murphy; Christine K Iannaccone; Taysir G Mahmoud; Michelle L Frits; Bing Lu; Ivan O Rosas; Paul F Dellaripa; Michael E Weinblatt; Elizabeth W Karlson; Nancy A Shadick; Tracy J Doyle Journal: Arthritis Rheumatol Date: 2019-08-04 Impact factor: 10.995
Authors: Emily K Wu; Zoe I Henkes; Brion McGowan; Richard D Bell; Moises J Velez; Alexandra M Livingstone; Christopher T Ritchlin; Edward M Schwarz; Homaira Rahimi Journal: J Immunol Date: 2019-10-28 Impact factor: 5.422