Inspirations About RA - ILD Save

Hello, I'm Jonathan Kaye reporting from EULAR twenty twenty four in Vienna. Interstitial lung disease and rheumatoid arthritis has been a hot topic at both EULAR and the American College of Rheumatology annual meetings for the past several years. The incidence of rheumatoid arthritis interstitial lung disease is about seven percent. This year at ULAR, there were several posters about rheumatoid arthritis associated lung disease. The first was a poster from Hong Kong where they looked at how they might be able to screen for interstitial lung disease in patients with rheumatoid arthritis at high risk for this.

Individuals who were seropositive, who had active disease. And they looked at patients and they performed high resolution CT scanning as their gold standard. And then they performed lung ultrasound where they looked for what are called bee lines. And they found that the presence of five or more bee lines on ultrasound yielded a sensitivity of about fifty five percent and a specificity of eighty seven percent for the detection of subclinical interstitial lung disease. And they proposed that using ultrasound is something that can be done at the bedside and doesn't require radiation exposure.

So, is an interesting approach to looking to screening for interstitial lung disease in patients with rheumatoid arthritis. Another poster was presented from the collaboration in the Nordic countries. This came out of Sweden, but looked at patients from Denmark, Finland, Iceland, Norway, and Sweden. And they looked at patients in the rheumatology registers from these countries who were initiating a first biologic or targeted synthetic DMARD patients with rheumatoid arthritis. They looked for incident cases of interstitial lung disease, and they found that there were a significant number of patients in the rheumatoid arthritis population who they could study and also in the general population as comparators.

And what they found was that the mortality from interstitial lung disease in patients with rheumatoid arthritis was similar to that for individuals with interstitial lung disease in the general population without rheumatoid arthritis. However, the presence of both rheumatoid arthritis and interstitial lung disease conferred an increased risk of mortality compared to patients with rheumatoid arthritis who did not have interstitial lung disease. So it's very important to screen for and identify interstitial lung disease and probably to treat interstitial lung disease among these patients with rheumatoid arthritis. So what is the cause of death among these patients with rheumatoid arthritis and interstitial lung disease? There was another poster from Spain that looked at a multicenter prospective cohort of patients with rheumatoid arthritis associated interstitial lung disease who were followed for a decade between 2013 and 2023, and they found that there was a high risk of serious infection among patients with interstitial lung disease.

Most of these were pulmonary infections, And of the individuals with pulmonary infections, there was a significant mortality. So, it's important, first of all, to screen for interstitial lung disease, and this might be done at the bedside with ultrasound if the study from Hong Kong can be generalized. And then once these patients are identified, they should be followed closely. And if they develop an infection, the infection should be identified promptly and treated so as to avoid the increased mortality that one sees in individuals with the combination of interstitial lung disease and rheumatoid arthritis. For information about this and other studies from EULAR twenty twenty four in Vienna, go to roomnow.com.

I'm Jonathan Kaye, and I look forward to seeing you again soon.