Lung function trajectory of rheumatoid arthritis-associated interstitial lung disease
- Abstract
- Objectives: To explore the course of lung function and RA disease activity and predictive factors for deteriorating lung function in patients with RA-interstitial lung disease (ILD).
Methods: The Korean Rheumatoid Arthritis-Interstitial Lung Disease cohort is a multicentre, prospective observational cohort. Patients with RA-ILD were enrolled and followed up annually for 3 years for RA disease activity and ILD status assessment. Group-based modelling was used to cluster a similar predicted percentage of forced vital capacity (FVC%) patterns into trajectories.
Results: This study included 140 patients who underwent at least two pulmonary function tests. Four distinctive trajectories for predicted FVC% were 'improving' [n = 11 (7.9%)], 'stable' [n = 68 (38.4%)], 'slowly declining' [n = 54 (48.6%)] and 'rapidly declining' [n = 7 (5.0%)]. Most (77.7%) patients maintained or improved to low RA disease activity. The lung function trajectory was not comparable to the RA disease activity trajectory. Age ≥70 years [relative risk (RR) 10.8 (95% CI 1.30, 89.71)] and early RA diagnosed within the preceding 2 years [RR 10.1 (95% CI 1.22, 84.2)] were associated with increased risk for rapidly declining predicted FVC%. The risk for deterioration or mortality increased in patients with a simultaneous diagnosis of RA and ILD within 24 weeks [RR 9.18 (95% CI 2.05, 41.0)] and the extent of lung involvement [RR 3.28 (95% CI 1.12, 9.60)].
Conclusion: Most patients with RA-ILD experienced stable or slowly declining lung function. In 5% of patients, predicted FVC% deteriorated rapidly, especially in older adults with early RA. The lung function trajectory was not comparable to the RA disease activity trajectory.
- All Author(s)
- S. H. Chang
; J. S. Lee
; Y. J. Ha
; M. U. Kim
; C. H. Park
; J. W. Kim
; S. W. Chung
; J. Y. Pyo
; S. W. Lee
; E. H. Kang
; Y. A. Lee
; Y. B. Park
; J. Y. Choe
; E. Y. Lee
- Issued Date
- 2023
- Type
- Article
- Keyword
- RA; interstitial lung disease; lung function trajectory; prospective cohort study
- Publisher
- British Society for Rheumatology
- ISSN
- 1462-0324
; 1462-0332
- Citation Title
- Rheumatology
- Citation Volume
- 62
- Citation Number
- 9
- Citation Start Page
- 3014
- Citation End Page
- 3024
- Language(ISO)
- eng
- DOI
- 10.1093/rheumatology/kead027
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/2097
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