Risk factors of interstitial lung diseases in patients with rheumatoid arthritis

Abstract

Objective: to identify risk factors for interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA). Material and Methods: The study included 167 patients, 73.1%- women, average age -52 (39; 60) years. A diagnosis of rheumatoid arthritis was made according to the American College of Rheumatology/ European League Against Rheumatism criteria by specialist rheumatologists, with an average number of points for 4 positions - 8.4±3.11. Median DAS28 was 4.8 (3.3; 6.4) points, positive for rheumatoid factor (RF) – 49 (73.1%). Anti-citrullinated protein antibodies (ACPAs) were detected in 45 (67.2%). ILD presence was confirmed during the detailed scoring of the computed tomography (CT) scans. Results: ILD was diagnosed in 26 (16%) patients with RA. The average time from diagnosis of RA to ILD was 5.2 years (range 3.2-11.9). The median follow-up was 1.8 years (0.01 to 3.5). Patients with RA were more frequently diagnosed with usual interstitial pneumonia (UIP) - 46% and nonspecific interstitial pneumonia – 31%. Pattern of UIP on CT was not associated with worsening of survival. The level of mortality correlated with the severity of lung injury (r-0.73; p Conclusion: Smoking, elderly age, male gender, high titers of ACPAs and RF are identified as risk factors for RA-ILD development.