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Published on: June 16, 2020
Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD): An Official 2025 ALAT Clinical Practice Guideline
María Laura Alberti1, Santiago José Auteri1, Jorge Rojas-Serrano2
1Hospital de Rehabilitación Respiratoria María Ferrer, Buenos Aires City, Argentina.
Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a major cause of death in RA patients. Early screening and achieving remission of joint activity are crucial for managing RA-ILD and improving patient prognosis.
Area of Science:
- Rheumatology
- Pulmonology
- Internal Medicine
Background:
- Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a severe complication and leading cause of mortality in rheumatoid arthritis (RA) patients.
- Usual interstitial pneumonia (UIP) is the most common form of ILD in RA, sharing features with idiopathic pulmonary fibrosis (IPF).
Purpose of the Study:
- To highlight the importance of early recognition of ILD in RA patients.
- To provide evidence-based guidelines for the management of RA-ILD.
- To emphasize the role of achieving articular activity remission in the treat-to-target strategy for mitigating ILD risk and progression.
Main Methods:
- Review of current literature and clinical guidelines regarding RA-ILD.
- Analysis of treatment strategies including disease-modifying antirheumatic drugs (DMARDs) and antifibrotics.
- Focus on screening protocols for early detection of ILD in RA.
Main Results:
- Early detection of ILD through screening can significantly alter treatment and prognosis for RA patients.
- Achieving remission of articular activity in RA is a key factor in preventing ILD development and progression.
- DMARDs and antifibrotic therapies are essential for managing RA-ILD and progressive pulmonary fibrosis.
Conclusions:
- Implementing early screening for ILD in RA patients is vital.
- Treating RA to achieve articular remission is a critical strategy to reduce ILD risk.
- A comprehensive management approach combining DMARDs and antifibrotics is necessary for patients with RA-ILD.
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