The Rheumatologist
COVID-19 NewsACR Convergence
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Gout Resource Center
      • Axial Spondyloarthritis Resource Center
      • Psoriatic Arthritis
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / Catch Your Breath: Insights into ILD in RA Patients

Catch Your Breath: Insights into ILD in RA Patients

September 12, 2019 • By Jason Liebowitz, MD

  • Tweet
  • Email
Print-Friendly Version / Save PDF

MADRID—Rheumatoid arthritis (RA) is among the most common autoimmune disease in the U.S., affecting approximately 1.3 million adults.1 Although tremendous treatment advances have been made in recent years, one extra-articular manifestation of RA that continues to pose a challenge with regard to detection and management is interstitial lung disease (ILD).

You Might Also Like
  • Insights into Interstitial Lung Disease in Rheumatoid Arthritis Patients
  • MUC5B Promoter Variant Associated with RA with Interstitial Lung Disease
  • RA Patients with ILD & Liver Disease Present Treatment Challenges
Also By This Author
  • The Great Debate: Should Jakinibs Be Used Before Biologics after Methotrexate Failure in RA?

At the 2019 European Congress of Rheumatology (EULAR), June 12–15, during a session titled, The Lung in Rheumatoid Arthritis, Iván Castellvi, MD, PhD, associate professor at the Universitat Autónoma, Barcelona, Spain, described the issues facing clinicians regarding ILD in RA. Dr. Castellvi began by noting that not all lung involvement in RA is ILD. Other diseases of the lung parenchyma in RA can include rheumatoid nodules, drug-induced pneumonitis and infections or malignancies that may or may not be directly related to RA and its treatment. Airway disease in RA include follicular bronchiolitis, obliterans bronchiolitis, bronchiectasis and arthritis of the cricothyroid joint. Vascular disease of the lung can manifest as pulmonary hypertension, pulmonary vasculitis and thromboembolic disease. Additionally, miscellaneous conditions can include Caplan’s syndrome, which describes the combination of RA and pneumoconiosis that manifests as intrapulmonary nodules that appear homogenous and well defined on chest radiography.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Risk Factors for ILD
Dr. Castellvi noted the evaluation of lung disease in RA patients involves assessing risk factors for the development of ILD, such as male sex, tobacco use, seropositivity for rheumatoid factor and/or the presence of antibodies to cyclic citrullinated peptide (anti-CCP) and disease severity.

The role genetics may play in this process was outlined in a 2018 article in The New England Journal of Medicine, marking an important contribution to this understanding. Given the phenotypic similarities between RA-associated ILD and idiopathic pulmonary fibrosis (IPF), the authors hypothesized the strongest risk factor for developing IPF—the gain-of-function MUC5B promoter variant rs35705950—may also be a risk factor for ILD in RA patients. In this study, more than 600 RA patients with ILD, 600 RA patients with no ILD and 5,400 unaffected controls were compared. The research showed the minor allele of the MUC5B promoter variant was associated with ILD in RA patients and that the MUC5B promoter variant was associated with an increased risk of ILD among RA patients, particularly those with a usual interstitial pneumonia (UIP) pattern on computed tomography (CT) imaging of the lungs.2

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

Although these associations will need further exploration, it’s helpful for clinicians to begin to understand the genetic underpinnings that may promote ILD development in RA patients. Such genetic information may become more widely accessible as more patients undergo genome sequencing.

Pages: 1 2 3 | Single Page

Filed Under: Conditions, Rheumatoid Arthritis Tagged With: EULAR, ILD, imaging, Interstitial Lung Disease, Methotrexate, Rheumatoid Arthritis (RA), Risk Factors

You Might Also Like:
  • Insights into Interstitial Lung Disease in Rheumatoid Arthritis Patients
  • MUC5B Promoter Variant Associated with RA with Interstitial Lung Disease
  • RA Patients with ILD & Liver Disease Present Treatment Challenges
  • Listen to the Lungs: An Interview with Dr. Aryeh Fischer on ILD

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use / Cookie Preferences

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2023 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)