Next Article in Journal
Phenotypic and Functional Alterations of Immune Effectors in Periodontitis; A Multifactorial and Complex Oral Disease
Next Article in Special Issue
Application of NGS Technology in Understanding the Pathology of Autoimmune Diseases
Previous Article in Journal
Is Neoadjuvant Treatment Justified in Clinical T1 Pancreatic Ductal Adenocarcinoma?
Previous Article in Special Issue
Renalase in Haemodialysis Patients with Chronic Kidney Disease
jcm-logo
Article Menu
Article

Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study

1
Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
2
UGC de Reumatología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
3
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), 14004 Córdoba, Spain
4
UGC de Reumatología, Hospital Universitario Reina Sofía de Córdoba, 14004 Córdoba, Spain
5
UGC de Reumatología, Hospital Clínico Universitario Virgen de la Victoria, 29010 Málaga, Spain
6
UGC de Neumología, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
7
UGC de Radiodiagnóstico, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
8
Hospital Universitario de Jaén, 23007 Jaén, Spain
9
Hospital Universitario Virgen de las Nieves, 18170 Granada, Spain
10
Hospital Universitario Virgen de Valme, 41014 Sevilla, Spain
11
Departamento de Medicina, Universidad de Málaga, 29010 Málaga, Spain
*
Authors to whom correspondence should be addressed.
Academic Editor: Agnieszka Paradowska-Gorycka
J. Clin. Med. 2021, 10(4), 874; https://doi.org/10.3390/jcm10040874
Received: 20 January 2021 / Revised: 12 February 2021 / Accepted: 16 February 2021 / Published: 20 February 2021
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. View Full-Text
Keywords: rheumatoid arthritis; interstitial lung disease; biologics; non-anti-TNF biologics rheumatoid arthritis; interstitial lung disease; biologics; non-anti-TNF biologics
Show Figures

Figure 1

MDPI and ACS Style

Mena-Vázquez, N.; Rojas-Gimenez, M.; Romero-Barco, C.M.; Manrique-Arija, S.; Francisco, E.; Aguilar-Hurtado, M.C.; Añón-Oñate, I.; Pérez-Albaladejo, L.; Ortega-Castro, R.; Godoy-Navarrete, F.J.; Ureña-Garnica, I.; Velloso-Feijoo, M.L.; Redondo-Rodriguez, R.; Jimenez-Núñez, F.G.; Panero Lamothe, B.; Padin-Martín, M.I.; Fernández-Nebro, A. Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study. J. Clin. Med. 2021, 10, 874. https://doi.org/10.3390/jcm10040874

AMA Style

Mena-Vázquez N, Rojas-Gimenez M, Romero-Barco CM, Manrique-Arija S, Francisco E, Aguilar-Hurtado MC, Añón-Oñate I, Pérez-Albaladejo L, Ortega-Castro R, Godoy-Navarrete FJ, Ureña-Garnica I, Velloso-Feijoo ML, Redondo-Rodriguez R, Jimenez-Núñez FG, Panero Lamothe B, Padin-Martín MI, Fernández-Nebro A. Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study. Journal of Clinical Medicine. 2021; 10(4):874. https://doi.org/10.3390/jcm10040874

Chicago/Turabian Style

Mena-Vázquez, Natalia, Marta Rojas-Gimenez, Carmen M. Romero-Barco, Sara Manrique-Arija, Espildora Francisco, María C. Aguilar-Hurtado, Isabel Añón-Oñate, Lorena Pérez-Albaladejo, Rafaela Ortega-Castro, Francisco J. Godoy-Navarrete, Inmaculada Ureña-Garnica, Maria L. Velloso-Feijoo, Rocio Redondo-Rodriguez, Francisco G. Jimenez-Núñez, Blanca Panero Lamothe, María I. Padin-Martín, and Antonio Fernández-Nebro. 2021. "Predictors of Progression and Mortality in Patients with Prevalent Rheumatoid Arthritis and Interstitial Lung Disease: A Prospective Cohort Study" Journal of Clinical Medicine 10, no. 4: 874. https://doi.org/10.3390/jcm10040874

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop