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oai:repisalud.isciii.es:20.500.12105/182652024-11-28T15:07:51Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16927col_20.500.12105_16982

00925njm 22002777a 4500 dc Mena-Vázquez, Natalia author Rojas-Gimenez, Marta author Romero-Barco, Carmen María author Manrique-Arija, Sara author Francisco, Espildora author Aguilar-Hurtado, María Carmen author Añón-Oñate, Isabel author Pérez-Albaladejo, Lorena author Ortega-Castro, Rafaela author Godoy-Navarrete, Francisco Javier author Ureña-Garnica, Inmaculada author Velloso-Feijoo, Maria Luisa author Redondo-Rodriguez, Rocio author Jimenez-Núñez, Francisco Gabriel author Panero Lamothe, Blanca author Padin-Martín, María Isabel author Fernández-Nebro, Antonio author 2021-02-20 Objectives: To describe a prospective cohort of patients with rheumatoid arthritis associated with interstitial lung disease (RA-ILD) and identify risk factors associated with disease progression and mortality in this cohort. Patients and methods: We performed a multicenter, prospective, observational study of patients with RA-ILD receiving disease-modifying antirheumatic drugs (DMARDs) between 2015 and 2020. The patients were assessed using high-resolution computed tomography and pulmonary function tests at baseline and at 60 months. The main endpoint was “Progression to ILD at the end of follow-up” in terms of the following outcomes: (1) improvement (i.e., improvement in forced vital capacity (FVC) ≥10% or diffusing capacity of the lungs for carbon monoxide (DLCO) ≥15% and absence of radiological progression); (2) nonprogression (stabilization or improvement in FVC ≤10% or diffusing capacity of the lungs for carbon monoxide (DLCO) <15% and absence of radiological progression); (3) progression (worsening of FVC >10% or DLCO >15% and radiological progression); or (4) death. We recorded demographic and clinical characteristics, lung function, and the incidence of adverse events. A Cox regression analysis was performed to identify factors associated with the worsening of ILD. Results: After 60 months, lung disease had stabilized in 66 patients (56.9%), improved in 9 (7.8%), and worsened in 23 (19.8%). Eighteen patients (15.5%) died, with a mean survival of 71.8 (1.9) months after diagnosis of ILD. The Cox multivariate analysis revealed the independent predictors of worsening of RA-ILD to be usual interstitial pneumonia (hazard ratio (HR), 2.6 (95%CI, 1.0–6.7)), FVC <80% (HR, 3.8 (95%CI, 1.5–6.7)), anticitrullinated protein antibody titers (HR, 2.8 (95%CI, 1.1–6.8)), smoking (HR, 2.5 (95%CI, 1.1–6.2)), and treatment with abatacept, tocilizumab, or rituximab (HR, 0.4 (95%CI, 0.2–0.8)). During follow-up, 79 patients (68%) experienced an adverse event, mostly infection (61%). Infection was fatal in 10/18 patients (55.5%) during follow-up. Conclusions: Lung function is stable in most patients with RA-ILD receiving treatment with disease-modifying anti-rheumatic drugs (DMARDs), although one-third worsened or died. Identifying factors associated with worsening in RA-ILD is important for clinical management. http://hdl.handle.net/10668/4143 http://hdl.handle.net/20.500.12105/18265 33672699 10.3390/jcm10040874 2077-0383 Journal of Clinical Medicine Rheumatoid arthritis Interstitial lung disease Biologics Non-anti-TNF biologics Antirheumatic drug Vital capacity Smoking Tomography Artritis reumatoide Enfermedades pulmonares intersticiales Productos biológicos Antirreumáticos Capacidad vital Fumar Tomografía Estudios de cohortes Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study