Screening of interstitial lung disease in patients with rheumatoid arthritis: A systematic review

Garrote-Corral, Sandra; Silva-Fernández, Lucía; Seoane‐Mato, Daniel; Guerra, Mercedes; Aburto, Myriam; Castañeda, Santos; Valenzuela, Claudia; Narváez, Javier

doi:10.1016/j.reumae.2021.07.002

Cited by 7 publications

(7 citation statements)

References 33 publications

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“…In this context it must be mentioned that a Spanish recommendation for ILD screening in RA patients was published after the Delphi consensus had been designed [ 35 , 36 ]. In this Delphi consensus, risk factors were weighted and an arbitrary cut-off of 5 points was chosen for conducting ILD screening in RA patients.…”

Section: Discussionmentioning

confidence: 99%

Screening for rheumatoid arthritis-associated interstitial lung disease—a Delphi-based consensus statement

Hackner,

Hütter,

Flick

et al. 2024

Z Rheumatol

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Objective Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a major driver of premature mortality in patients with rheumatoid arthritis (RA). Detection of RA-ILD is crucial but requires awareness among the treating physicians. To date, however, there is no international recommendation concerning screening for ILD in RA patients. Methods After a systematic literature review, the modified Delphi technique in combination with the nominal group technique was used to provide a Delphi consensus statement elaborated by an expert panel of pneumonologists, rheumatologists, and a radiologist. Based on the available evidence, several clusters of questions were defined and discussed until consent was reached. Results A screening algorithm for ILD in patients with RA based on clinical signs, respiratory symptoms, and risk factors has been developed. Further, the recommendations address diagnostic tools for RA-ILD and the follow-up of RA patients qualifying for ILD screening.

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Section: Discussionmentioning

confidence: 99%

Screening for rheumatoid arthritis-associated interstitial lung disease—a Delphi-based consensus statement

Hackner,

Hütter,

Flick

et al. 2024

Z Rheumatol

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“…All the above mentioned is reflected in the wide heterogeneous prevalence reported in current literature, which ranges from 1% to 61%. [25][26][27][28][29][30] Large studies based on administrative structured data sets built on the International Classification of Disease coding, estimates RAILD prevalence between 2% and 6% among the RA population. 4 26 31 Yet the complexity claims-based algorithm limits the ability to accurately identify RAILD (positive predictive value 44-72%).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical characteristics of patients with rheumatoid arthritis with interstitial lung disease using unstructured healthcare data and machine learning

Román Ivorra,

Trallero-Araguas,

Lopez Lasanta

et al. 2024

RMD Open

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ObjectivesReal-world data regarding rheumatoid arthritis (RA) and its association with interstitial lung disease (ILD) is still scarce. This study aimed to estimate the prevalence of RA and ILD in patients with RA (RAILD) in Spain, and to compare clinical characteristics of patients with RA with and without ILD using natural language processing (NLP) on electronic health records (EHR).MethodsObservational case–control, retrospective and multicentre study based on the secondary use of unstructured clinical data from patients with adult RA and RAILD from nine hospitals between 2014 and 2019. NLP was used to extract unstructured clinical information from EHR and standardise it into a SNOMED-CT terminology. Prevalence of RA and RAILD were calculated, and a descriptive analysis was performed. Characteristics between patients with RAILD and RA patients without ILD (RAnonILD) were compared.ResultsFrom a source population of 3 176 165 patients and 64 241 683 EHRs, 13 958 patients with RA were identified. Of those, 5.1% patients additionally had ILD (RAILD). The overall age-adjusted prevalence of RA and RAILD were 0.53% and 0.02%, respectively. The most common ILD subtype was usual interstitial pneumonia (29.3%). When comparing RAILD versus RAnonILD patients, RAILD patients were older and had more comorbidities, notably concerning infections (33.6% vs 16.5%, p<0.001), malignancies (15.9% vs 8.5%, p<0.001) and cardiovascular disease (25.8% vs 13.9%, p<0.001) than RAnonILD. RAILD patients also had higher inflammatory burden reflected in more pharmacological prescriptions and higher inflammatory parameters and presented a higher in-hospital mortality with a higher risk of death (HR 2.32; 95% CI 1.59 to 2.81, p<0.001).ConclusionsWe found an estimated age-adjusted prevalence of RA and RAILD by analysing real-world data through NLP. RAILD patients were more vulnerable at the time of inclusion with higher comorbidity and inflammatory burden than RAnonILD, which correlated with higher mortality.

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“…Although HRCT is the gold standard for ILD screening, there is a need to validate other radiation-free, readily available, noninvasive, bedside screening techniques such as lung ultrasound [ 41 , 42 ]. As more information becomes available, the inclusion of ultrasound in the algorithm will be considered based on the high sensitivity observed to date.…”

Section: Discussionmentioning

confidence: 99%

Delphi-Based Consensus on Interstitial Lung Disease Screening in Patients with Connective Tissue Diseases (Croatian National-Based Study)

et al. 2022

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The aim of this study was to develop a Croatian Delphi-based expert consensus for screening interstitial lung disease (ILD) associated with connective tissue disease (CTD). A systematic literature review was conducted on risk factors for the development of ILD, prevalence and incidence of ILD, diagnostic and screening methods for ILD, and prognosis of ILD in idiopathic inflammatory myopathy (IIM), mixed connective tissue disease (MCTD), primary Sjögren’s syndrome (pSS), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) were performed. Based on the evidence found, experts developed questionnaires for screening and monitoring ILD in each CTD, which were provided via an online survey. Following the electronic survey, two screening algorithms were developed based on the consensus opinions. The detection strategy for ILD included high-resolution computed tomography (HRCT) in addition to pulmonary function testing for IIM, MCTD, and SSc. and pulmonary function testing for newly diagnosed pSS, RA and SLE. However, in patients with identified risk factors for ILD HRCT, these tests should also be performed. A screening strategy for early identification of patients with various CTD-ILD was first developed by a multidisciplinary team of rheumatologists, pulmonologists, and radiologists to identify early CTD patients at risk of ILD, a severe extra-articular manifestation of CTD.

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Screening of interstitial lung disease in patients with rheumatoid arthritis: A systematic review

Cited by 7 publications

References 33 publications

Screening for rheumatoid arthritis-associated interstitial lung disease—a Delphi-based consensus statement

Screening for rheumatoid arthritis-associated interstitial lung disease—a Delphi-based consensus statement

Prevalence and clinical characteristics of patients with rheumatoid arthritis with interstitial lung disease using unstructured healthcare data and machine learning

Delphi-Based Consensus on Interstitial Lung Disease Screening in Patients with Connective Tissue Diseases (Croatian National-Based Study)

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