The Lung in Rheumatoid Arthritis
Top Cited Papers
- 27 May 2018
- journal article
- review article
- Published by Wiley in Arthritis & Rheumatology
- Vol. 70 (10), 1544-1554
- https://doi.org/10.1002/art.40574
Abstract
Interstitial lung disease (ILD) is an increasingly recognized complication of rheumatoid arthritis (RA) and is associated with significant morbidity and mortality. In addition, approximately one‐third of patients have subclinical disease with varying degrees of functional impairment. Although risk factors for RA‐related ILD are well established (e.g., older age, male sex, ever smoking, and seropositivity for rheumatoid factor and anti–cyclic citrullinated peptide), little is known about optimal disease assessment, treatment, and monitoring, particularly in patients with progressive disease. Patients with RA‐related ILD are also at high risk of infection and drug toxicity, which, along with comorbidities, complicates further treatment decision‐making. There are distinct histopathologic patterns of RA‐related ILD with different clinical phenotypes, natural histories, and prognoses. Of these, the usual interstitial pneumonia (UIP) subtype of RA‐related ILD shares a number of clinical and histopathologic features with idiopathic pulmonary fibrosis, the most common and severe of the idiopathic interstitial pneumonias, suggesting the existence of common mechanistic pathways and possibly therapeutic targets. There remain substantial gaps in our knowledge of RA‐related ILD. Concerted multinational efforts by expert centers has the potential to elucidate the basic mechanisms underlying RA‐related UIP and other subtypes of RA‐related ILD and facilitate the development of more efficacious and safer drugs.Keywords
Funding Information
- Università degli Studi di Padova (BIRD163522)
This publication has 81 references indexed in Scilit:
- Acute exacerbation in rheumatoid arthritis-associated interstitial lung disease: a retrospective case control studyBMJ Open, 2013
- Pleuro-Pulmonary Complications of Rheumatoid ArthritisRespiratory Care, 2013
- Fibrosing interstitial pneumonia predicts survival in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD)Respiratory Medicine, 2013
- Mycophenolate Mofetil Improves Lung Function in Connective Tissue Disease-associated Interstitial Lung DiseaseThe Journal of Rheumatology, 2013
- Prednisone, Azathioprine, andN-Acetylcysteine for Pulmonary FibrosisNew England Journal of Medicine, 2012
- Incidence of Extraarticular Rheumatoid Arthritis in Olmsted County, Minnesota, in 1995–2007 Versus 1985–1994: A Population-based StudyThe Journal of Rheumatology, 2011
- An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and ManagementAmerican Journal of Respiratory and Critical Care Medicine, 2011
- Interstitial lung disease has a poor prognosis in rheumatoid arthritis: results from an inception cohortRheumatology, 2010
- Rheumatoid Arthritis-Associated Interstitial Lung Disease: The Relevance of Histopathologic and Radiographic PatternChest, 2009
- Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: a systematic literature researchAnnals Of The Rheumatic Diseases, 2008