Changing patterns of pulmonary abnormalities in rheumatoid arthritis

Tanaka, Ayae; Kurasawa, Kazuhiro; Soda, Sayo; Takamura, Yuta; Miyao, Tomoyuki; Hasegawa, Anna; Hiyama, Tomoka; Yamazaki, Risa; Arai, Satoko; Owada, Takayoshi; Arima, Masafumi; Arakawa, Hiroaki; Maezawa, Reika

doi:10.1016/j.resinv.2022.09.002

Cited by 1 publication

(5 citation statements)

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“…In addition, SAD has been associated with important markers of RA, including disease activity, joint erosions, RF, and anti‐CCP (Singh et al., 2022). Although we evaluated patients with RA‐ILD, inflammation of the small airways can induce nodular lesions and interstitial pneumonia; in fact, SAD has been recently identified as the possible initial abnormality in the genesis of lung damage in patients with RA (Tanaka et al., 2023).…”

Section: Discussionmentioning

confidence: 99%

“…RA affects not only the joints but also several other organs, such as the lungs. In fact, pulmonary involvement occurs in 60%–80% of patients with RA and can affect all components of the lungs, contributing substantially to morbidity and mortality (Spagnolo et al., 2018; Tanaka et al., 2023). Because lung damage complicates the treatment of RA, the management of lung involvement and pulmonary rehabilitation strategies in these patients are important (Tanaka et al., 2023).…”

Section: Introductionmentioning

confidence: 99%

“…Although the involvement of the respiratory system can be quite varied in RA, the most common lesions are interstitial lung disease (ILD), airway disease, rheumatoid nodules, pleural disease, and vascular disease (Tanaka et al., 2023). RA‐associated interstitial lung disease (RA‐ILD) is the second‐leading cause of death in patients with RA, with a 5‐year mortality rate of 35% (Raimundo et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

“…RA‐associated interstitial lung disease (RA‐ILD) is the second‐leading cause of death in patients with RA, with a 5‐year mortality rate of 35% (Raimundo et al., 2019). RA‐ILD has a spectrum of manifestations ranging from inflammation to fibrosis (Tanaka et al., 2023). Despite the importance of RA‐ILD, the presence of functional or morphological abnormalities in the small airways is one of the findings commonly described.…”

Section: Introductionmentioning

confidence: 99%

“…However, as the lungs are one of the most often affected sites in RA, there is a need to evaluate the contribution of lung damage to the CPF (Ye et al., 2022). Since airway disease has been identified as a common abnormality in RA, including being a precursor of later pulmonary abnormalities, it is necessary to test its inclusion in explanatory models for CPF (Tanaka et al., 2023). Thus, the objective of this study was to derive a predictive equation for VO 2peak by simple sampling technology for women with RA‐ILD, taking into account the variables of pulmonary involvement.…”

Section: Introductionmentioning

confidence: 99%

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Estimating cardiopulmonary fitness with a new sampling technology in patients with rheumatoid arthritis‐associated interstitial lung disease

Deucher

Reis

Papathanasiou

et al. 2023

Physiotherapy Res Intl

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Background and Objectives Although peak oxygen uptake (VO2peak) is one of the most important measures in clinical practice, the high cost and time consumption have led to the search for simpler devices and the development of the estimating cardiopulmonary fitness (eCPF) equation. Since the lungs are one of the sites most affected by rheumatoid arthritis (RA), this study aimed to create a predictive equation for VO2peak obtained by simple sampling technology in women with RA‐associated interstitial lung disease (RA‐ILD). Methods This cross‐sectional study evaluated 47 women with RA‐ILD. The participants underwent the following evaluations: computed tomography (CT); evaluation of disease activity through the Clinical Disease Activity Index (CDAI); measurement of physical function using the Health Assessment Questionnaire disability index (HAQ‐DI); pulmonary function testing, including spirometry, diffusing capacity for carbon monoxide (DlCO), nitrogen single‐breath washout (N2SBW) test, and impulse oscillometry; and cardiopulmonary exercise testing (CPET) using FitMate™. Results VO2peak was correlated with age (r = −0.550, p < 0.0001), rheumatoid factor (r = −0.443, p = 0.002), anti‐cyclic citrullinated peptide antibodies (r = −0.410, p = 0.004), CDAI (r = −0.462, p = 0.001), HAD‐DI (r = −0.486, p = 0.0005), forced vital capacity (r = 0.491, p = 0.0004), DlCO (r = 0.621, p < 0.0001), phase III slope of N2SBW (r = −0.647, p < 0.0001), resonance frequency (Fres, r = −0.717, p < 0.0001), integrated low‐frequency reactance (r = −0.535, p = 0.0001), and the inhomogeneity of respiratory system resistance between 4 and 20 Hz (r = −0.631, p < 0.0001). In the CT examination, patients with extensive ILD had significantly lower VO2peak than patients with limited ILD (p < 0.0001). In the stepwise forward regression analysis, Fres, DlCO and age explained 61% of the VO2peak variability. Conclusions As assessed by CPET, women with RA‐ILD show reduced cardiopulmonary fitness, which can be explained at least in part by the presence of small airway disease, deterioration of pulmonary gas exchange, and advanced age. These associations of pulmonary variables with eCPF may be clinically important and support the use of the eCPF equation to improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%