SAIL-RA: Finging ILD in Early RA Save

Cohort study of early rheumatoid arthritis (RA) patients finds that interstitial lung disease (ILD) begins early in the course of RA, with certain factors enhancing tihs risk.

 

A cross-sectional analysis of the prospective Study of Inflammatory Arthritis and Interstitial Lung Disease in Early RA (SAIL-RA) included early RA patients (defined as RA < 2 years duration). These patients were followed with surveys, medical history, HRCT chest imaging, pulmonary function tests, and laboratory testing for autoantibodies. 

 

The SAIL-RA cohort included 172 patients who completed HRCT chest imaging and other measures - these were 74% female, with a mean age of 55 years; they were 74% CCP+ and 68% RF+.  The median RA disease duration was 0.79 years.

 

RA-associated ILD on HRCT was found in 19 (11%). Factors predictive of RA-ILD, included high DAS28-ESR > 3.2 (adjusted OR 7·00 [95% CI 1·95–25·13]) and age >60 years (aOR 3.87 [1·33–11·27]). 

 

The number of patients with early rheumatoid arthritis who needed to be screened to detect one case of RA-ILD ranged from 3.6 to 7.7.

 

Amongst this cohort of early RA patients, 11% had RA-ILD, that could have been suggested by increasing disease activity and age. Screening strategies may be modified to include these findings, as current guidelines suggest RA patients should be screened for ILD if ILD risk factors are present (eg, seropositivity, males, smoking, etc.).