THU0671 PULMONARY INVOLVEMENT IN RHEUMATOID ARTHRITIS: PATTERNS AND EPIDEMIOLOGICAL CHARACTERISTICS FROM A MONOCENTRIC COHORT STUDY

Abstract

Background: Extra-articular manifestations (EAM) are not an uncommon finding in patients with Rheumatoid Arthritis (RA). Pulmonary involvement is a potential life-threatening EAM with deleterious effects on the quality of life and is reported in different occurrence among studies. Objectives: To evaluate the frequency of pulmonary involvement in RA patients followed-up in a 15-years period. Methods: 549 RA patients were diagnosed according to the ACR/EULAR classification criteria since 2003. A full clinical examination as well as a detailed laboratory and immunological evaluation has been carried-out at baseline. Furthermore, chest, hand and wrist but also feet radiographs had been obtained. All patients were followed-up at predefined times and were treated appropriately with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and/or biologic (b)DMARDs. Any laboratory abnormalities or comorbidities were recorded and investigated appropriately at every visit. In addition, the disease activity score (DAS) using the 28-joints count (DAS-28) was recorded. Results: Initial evaluation revealed 15 patients as having pulmonary abnormalities. Thus, these patients were excluded. From the rest, 37 (6.7%) patients manifested lung involvement. There were 26 males and 11 females, with mean age of 62.9 ±3.4 years and disease duration of 8.5 ±2.2 years. 14 were smokers and 10 ex-smokers. Dry cough and dyspnea on exertion were the main pulmonary symptoms. High resolution computed tomography (HRCT) scan of the chest revealed interstitial lung disease (ILD). More specifically, 23 patients showed usual interstitial pneumonia (UIP), 10 patients had nonspecific interstitial pneumonia (NSIP), while 4 had a mixed pattern. Six patients died 4 years after ILD development. ILD was associated with high DAS-28, seropositivity and male gender. Conclusion: ILD is not a frequent EAM in patients with RA, but it carries a poor prognosis with high morbidity and mortality and it is associated with RA disease activity and male gender. UIP is the most prevalent pattern of ILD in RA patients. Disclosure of Interests: None declared