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Rheumatoid arthritis related interstitial lung disease - improving outcomes over 25 years: a large multicentre UK
Clive A Kelly1, Mohamed Nisar2, Suba Arthanari2
1Department of Cellular Medicine, University of Newcastle upon Tyne, Gateshead, UK.
Rheumatology (Oxford, England)
|November 5, 2020
Summary
Survival for rheumatoid arthritis with interstitial lung disease (RA-ILD) has improved over time. Newer biologic therapies, particularly rituximab, show promise in enhancing patient outcomes compared to anti-TNF agents.
Area of Science:
- Rheumatology
- Pulmonology
- Clinical Epidemiology
Background:
- Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) poses a significant mortality risk.
- Understanding trends in RA-ILD prognosis and the impact of treatments is crucial for patient care.
Purpose of the Study:
- To investigate if the prognosis of RA-ILD has improved over a 25-year period.
- To assess the influence of specific drug therapies on mortality in RA-ILD patients.
Main Methods:
- A retrospective analysis of 290 RA-ILD patients from 18 UK centers diagnosed over 25 years.
- Comparison of all-cause and respiratory mortality with rheumatoid arthritis (RA) controls.
- Assessment of drug therapy effects on mortality, stratified by diagnosis year quartiles.
Main Results:
- Overall prognosis for RA-ILD improved, with median age at death increasing from 63 to 78 years.
- Anti-TNF therapy was associated with increased mortality risk (RR 2.09), while rituximab and mycophenolate showed lower risks.
- Rituximab as first-line biologic therapy improved survival rates compared to anti-TNF agents.
Conclusions:
- Survival for RA-ILD patients has significantly improved over the past 25 years.
- The use of specific immunosuppressive and biologic agents, such as rituximab, may contribute to this improved survival.
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