Abstract
Interstitial lung disease (ILD) is the most common extra-articular manifestation of rheumatoid arthritis (RA). RA-ILD seems to differ from ILD related to other connective tissue diseases regarding the high prevalence of the fibrotic pattern, a severe prognosis, and a low efficacy of immunosuppressive drugs. The most frequent ILD subtype identified in RA is the usual interstitial pneumonia, which shares similarities with idiopathic pulmonary fibrosis such as common risk factors and a worse prognosis. To date, because of the lack of controlled studies, no recommendation about the management of RA-ILD can be made. However, results from recent retrospective studies support a rationale for further controlled studies on methotrexate and abatacept. Due to its high frequency, a long preclinical phase and the high mortality rate, RA-ILD should require a special attention from rheumatologists.
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