Takuya Kakutani1, Atsushi Hashimoto1, Akito Tominaga1, Kako Kodama1, Shinichi Nogi1, Hirotaka Tsuno1, Hideki Ogihara1, Takahiro Nunokawa1, Akiko Komiya2, Hiroshi Furukawa3,4, Shigeto Tohma4,5, Toshihiro Matsui1,4. 1. Department of Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan. 2. Department of Clinical Laboratory, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan. 3. Molecular and Genetic Epidemiology Laboratory, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 4. Clinical Research Center for Allergy and Rheumatology, National Hospital Organization Sagamihara National Hospital, Sagamihara, Japan. 5. National Hospital Organization Tokyo National Hospital, Kiyose, Japan.
Abstract
Objectives: Interstitial lung disease (ILD) is a life-threatening extra-articular manifestation of rheumatoid arthritis (RA). We aimed to clarify the relationship between chronic ILD with a pattern of usual interstitial pneumonia (UIP) or non-UIP and mortality in RA patients. Methods: We retrospectively surveyed information of consecutive RA patients who visited our hospital from 2009 to 2014. The relationship between their mortality and chronic ILD (UIP or non-UIP) detected by high-resolution computed tomography was examined. Results: Of 2702 patients enrolled, 261 (9.7%) had chronic ILD and among these 120 had a UIP pattern. At the onset of RA, the prevalence of chronic ILD was 6%. Patients with chronic ILD had a higher mortality than those without. The most frequent cause of death was pneumonia including acute exacerbation (AE) of chronic ILD. Lung cancer death was frequently identified in deceased patients with chronic ILD with a UIP pattern compared with the other decedents (p=.062). The estimated mortality of lung cancer in patients with chronic ILD with a UIP pattern was five times higher than the general population. Conclusion: RA patients with ILD with a UIP pattern have a high mortality rate and are prone to die of AE or lung cancer.
Objectives:Interstitial lung disease (ILD) is a life-threatening extra-articular manifestation of rheumatoid arthritis (RA). We aimed to clarify the relationship between chronic ILD with a pattern of usual interstitial pneumonia (UIP) or non-UIP and mortality in RApatients. Methods: We retrospectively surveyed information of consecutive RApatients who visited our hospital from 2009 to 2014. The relationship between their mortality and chronic ILD (UIP or non-UIP) detected by high-resolution computed tomography was examined. Results: Of 2702 patients enrolled, 261 (9.7%) had chronic ILD and among these 120 had a UIP pattern. At the onset of RA, the prevalence of chronic ILD was 6%. Patients with chronic ILD had a higher mortality than those without. The most frequent cause of death was pneumonia including acute exacerbation (AE) of chronic ILD. Lung cancer death was frequently identified in deceased patients with chronic ILD with a UIP pattern compared with the other decedents (p=.062). The estimated mortality of lung cancer in patients with chronic ILD with a UIP pattern was five times higher than the general population. Conclusion:RApatients with ILD with a UIP pattern have a high mortality rate and are prone to die of AE or lung cancer.
Authors: Natalia Mena-Vázquez; Francisco Gabriel Jimenez-Núñez; Francisco Javier Godoy-Navarrete; Sara Manrique-Arija; María Carmen Aguilar-Hurtado; Carmen María Romero-Barco; Inmaculada Ureña-Garnica; F Espildora; María Isabel Padin-Martín; Antonio Fernández-Nebro Journal: Clin Rheumatol Date: 2021-02-21 Impact factor: 2.980