LUNG DAMAGE IN RHEUMATOID ARTHRITIS - A PROSPECTIVE ANALYSIS

The objective of this prospective study was to make correlations between demographic and rheumatoid arthritis (RA)-related characteristics and the type and severity of the interstitial lung involvement (ILD), being able to quantify a potential "gold standard" in predicting the development of these extra-articular manifestations (EAMs) that worsen the disease and increase the morbidity. Materials and methods: 60 RA patients were included in the analysis over a period of 2 years and the following data were centralized: demographic characteristics, the presence of lung damage quantified by pulmonary high-resolution computed tomography (HRCT), the presence of specific RA antibodies (anticitrullinated peptide antibodies - ACPAs), duration and activity of RA, pulmonary function measured by diffusing capacity for carbon monoxide (DLCO). Using different statistical tests, we analyzed the correlations between these parameters, trying to highlight the possible risk factors involved in the appearance of pulmonary manifestations in RA. Results: We included in our prospective study 60 patients, mostly women (n=46; 76.7%) with a mean age of 63.02 +/- 10 years old and with a mean age of disease onset of 51.89 years (95% CI: 48.86 to 54.93). Out of the 60 cases, data on smoking status was available for 34 participants, 82.4% being non-smokers, while 17.6% having an active smoker status. Regarding pulmonary function tests, 60% of the patients showed a decreased DLCO. More than half of the subjects (63.18%) had increased values of ACPAs. The results obtained were promising, demonstrating a direct relationship between both the DLCO decrease and the presence of specific ACPA antibodies, as well as between the appearance of lung-specific changes on HRCT and the increased titer of ACPAs. Also, the decrease in lung function was correlated with the radiological manifestations highlighted on HRCT. Conclusions: The presented study supports the close relationship between AR and ILD, pointing out the need for a careful pulmonary evaluation in these patients. The more active the disease, the higher the risk of developing lung damage. An early diagnosis and an adequate treatment can improve the prognosis of these patients.