Interstitial lung disease has a poor prognosis in rheumatoid arthritis: results from an inception cohort

Koduri, Gouri; Norton, Sam; Young, Adam; Cox, Nigel; Davies, Paul; Devlin, Joe; Dixey, Josh; Gough, Andrew; Prouse, P.; Winfield, John B.; Williams, Peter

doi:10.1093/rheumatology/keq035

Cited by 295 publications

(248 citation statements)

References 36 publications

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“…Other investigators have observed that age, a rheumatoid arthritis disease activity score [13,15], UIP-pattern on HRCT, DLCO % pred at presentation and sex (female protective) [6,15] were significant predictors of mortality. The current study builds on past work from our group: in a prior study, we examined clinical predictors of outcome in RA-ILD defined by lung biopsy and found that age and the presence of any fibrosis on biopsy (UIP, fibrotic NSIP, or unclassifiable fibrosing ILD) predicted mortality [8].…”

Section: Discussionmentioning

confidence: 90%

“…ILD is a common manifestation of rheumatoid arthritis, with a prognosis that is generally, but not universally, poor [13]. With 1% of the US population affected by rheumatoid arthritis, and an estimated 7% of all deaths in rheumatoid arthritis related to ILD, ILD is not a trivial concern for rheumatoid arthritis patients and the practitioners caring for them [3].…”

Section: Discussionmentioning

confidence: 99%

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Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease

et al. 2015

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Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis. There is lack of clarity around predictors of mortality and disease behaviour over time in these patients.We identified rheumatoid arthritis-related interstitial lung disease (RA-ILD) patients evaluated at National Jewish Health (Denver, CO, USA) from 1995 to 2013 whose baseline high-resolution computed tomography (HRCT) scans showed either a nonspecific interstitial pneumonia (NSIP) or a "definite" or "possible" usual interstitial pneumonia (UIP) pattern. We used univariate, multivariate and longitudinal analytical methods to identify clinical predictors of mortality and to model disease behaviour over time.The cohort included 137 subjects; 108 had UIP on HRCT (RA-UIP) and 29 had NSIP on HRCT (RA-NSIP). Those with RA-UIP had a shorter survival time than those with RA-NSIP (log rank p=0.02). In a model controlling for age, sex, smoking and HRCT pattern, a lower baseline % predicted forced vital capacity (FVC % pred) (HR 1.46; p<0.0001) and a 10% decline in FVC % pred from baseline to any time during follow up (HR 2.57; p<0.0001) were independently associated with an increased risk of death.Data from this study suggest that in RA-ILD, disease progression and survival differ between subgroups defined by HRCT pattern; however, when controlling for potentially influential variables, pulmonary physiology, but not HRCT pattern, independently predicts mortality. @ERSpublications In rheumatoid-arthritis associated interstitial lung disease, physiology, and not HRCT pattern, predicts mortality

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease

et al. 2015

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“…The most common CTD associated with associated ILD are scleroderma, polymyositis, dermatomyositis, systemic lupus erythematosus and rheumatoid arthritis. In a study by Koduri et al [67] it was noted that in patients with rheumatoid arthritis associated ILD, Risk of death was almost double in patients with low socio-economic status.…”

Section: Interstitial Lung Diseasementioning

confidence: 99%

Socioeconomic Status and Its Relationship to Chronic Respiratory Disease

Sahni

Talwar

Khanijo

et al. 2017

Advances in Respiratory Medicine

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Socioeconomic status (SES) is defined as an individual's social or economic standing, and is a measure of an individual's or family's social or economic position or rank in a social group. It is a composite of several measures including income, education, occupation, location of residence or housing. Studies have found a lower SES has been linked to disproportionate access to health care in many diseases. There is emerging data in pulmonary diseases such as COPD, asthma, cystic fibrosis, pulmonary hypertension and other chronic respiratory conditions that allude to a similar observation noted in other chronic diseases. In the setting of COPD, SES has an inverse relationship with COPD prevalence, mortality, health utilization costs and HRQoL. Asthma and cystic fibrosis show an increased severity and hospitalizations in relationship to a lower SES. Similar observations were seen in sarcoidosis, PHTN and obstructive sleep apnea. There remains a limited data on non-CF bronchiectasis and interstitial lung diseases. Population SES may be gauged by various measures such as education, occupation, marital status but no value is more indicative than income. Currently guidelines and management algorithms do not factor the effect of SES in the disease process. Despite the great amount of data available, a standardized method must be created to include SES in the prognostic calculations and management of chronic pulmonary diseases.

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“…Eroziv eklem hasar›n›n varl›¤›, yüksek eritrosit sedimantasyon h›z›, yüksek titrede romatoid faktör ya da anti-CCP pozitifli¤i ve romatoid nodül varl›¤› ‹AH geliflmesi için risk oluflturmaktad›r. [38][39][40] [41] Klinik semptomlar ortaya ç›kt›k-tan sonra s›kl›kla hastal›k, kötü yönde ilerleme gösterir. Zamanla olan kötüleflme, klinik bulgular›n türüne ve ‹AH'›n radyolojik/histopatolojik tipine göre de¤ifliklik gösterir.…”

Section: Risk Faktörleriunclassified

Rheumatoid arthritis-associated interstitial lung disease

Beş¹

2015

RAED Derg

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Interstitial lung disease has a poor prognosis in rheumatoid arthritis: results from an inception cohort

Abstract: RA-ILD is an important and early feature of RA. It is related to disease activity and has a poor prognosis. Further studies are required to determine whether screening for pulmonary disease would identify these patients at an earlier stage.

Cited by 295 publications

References 36 publications

Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease

Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease

Socioeconomic Status and Its Relationship to Chronic Respiratory Disease

Rheumatoid arthritis-associated interstitial lung disease

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