POS0619 CLINICAL AND SUBCLINICAL INTERSTITIAL LUNG DISEASE IN RHEUMATOID ARTHRITIS: ASSOCIATED FACTORS.

Abstract

ObjectivesTo evaluate the differences between patients with rheumatoid arthritis (RA) with and without interstitial lung disease (ILD), to identify factors associated with the development of ILD and to evaluate subclinical ILD; prevalence and factors associated with its development.MethodsObservational and cross-sectional study of a cohort of patients with RA (ACR/EULAR 2010) and with ILD and a control group of patients without ILD. Both groups with HRCT performed in the last 18 months. The date of the last HRCT was considered as the study date. The % of patients who had subclinical ILD was retrospectively evaluated, defining this as pulmonary involvement due to a requested HRCT without any previous respiratory symptoms. Demographic variables, activity data (DAS28VSG, SDAI and CDAI on the study date), RF and ACPA levels, RA severity data and treatments they were receiving were collected. Descriptive analysis, χ2 or t-Student and multivariate logistic regression analysis was performed to find predictive variables of the development of ILD.Results66 patients with RA (41 with ILD and 25 without ILD) were included. The main differences between both groups are shown in Table 1. In the group of patients with ILD, the male sex predominated, they were older, with a longer duration of the disease and a longer diagnostic delay of RA. They made more use of biological therapies with better control of the disease by DAS28, SDAI and CDAI. Pulmonary function preserved by respiratory function tests. Of the total number of patients with ILD, 15 (36.6%) did not present any respiratory symptoms when the HRCT was requested. The reasons for their request were: finding abnormalities on chest X-ray (66.7%) and dry crackles on examination (33.3%). Subclinical ILDs were diagnosed with less evolution time of RA than clinical ones. In the rest of the variables there were no differences with the clinical ILD. The variables independently associated with the development of ILD, adjusted for age, tobacco use and ACPA at high titers, were male sex [OR = 4.2 (95% CI 1.05-19.7), p = 0.049] and time of evolution of RA [OR = 1.08 (95% CI 1.02-1.17), p = 0.014].ConclusionIn our cohort, the prevalence of subclinical ILD was high (36%). Clinical characteristics, disease activity and ILD data (PFT and HRCT patterns) were similar between clinical and subclinical ILD, but prospective studies are needed to assess whether the course and prognosis in both groups is also similar. Bearing in mind that ILD is an important cause of death in our patients, we must actively search for this condition in order to treat it early and improve its prognosis.Disclosure of InterestsNone declared