Exploring Antifibrotic Strategies for Interstitial Lung Disease in Rheumatoid Arthritis: A Narrative Review

Area of Science:

• Rheumatology
• Pulmonology
• Immunology

Background:

• Rheumatoid arthritis (RA) is an autoimmune disease with potential extra-articular manifestations, including interstitial lung disease (ILD).
• Usual interstitial pneumonia and nonspecific interstitial pneumonia are common ILDs in RA, leading to lung fibrosis and poorer prognoses.
• The exact mechanisms driving ILD in RA are not fully understood, but involve environmental, genetic, and immune factors.

Purpose of the Study:

• To compare the fibrotic lung disease development in rheumatoid arthritis (RA) with idiopathic pulmonary fibrosis (IPF).
• To explore the potential of antifibrotic agents in treating fibrotic ILD associated with RA.

Main Methods:

• Comparative analysis of the pulmonary fibrotic process in RA and IPF.
• Review of existing literature on ILD in RA and antifibrotic treatments.

Main Results:

• Similarities in pathogenesis and inflammatory pathways between RA-ILD and IPF suggest a shared underlying mechanism for lung fibrosis.
• Current RA treatments show limited efficacy in managing progressive pulmonary fibrosis.

Conclusions:

• Antifibrotic drugs, successful in IPF treatment, represent a promising therapeutic strategy for fibrotic lung changes in RA.
• Further large-scale clinical trials are essential to validate the efficacy and safety of antifibrotic agents for RA-ILD.