Clinical features of acute exacerbation in rheumatoid arthritis–associated interstitial lung disease: Comparison with idiopathic pulmonary fibrosis

• Published in: Respiratory medicine 2022-08, Vol.200, p.106898-106898, Article 106898
• Main Authors: Otsuka, Junji, Yoshizawa, Shigeru, Kudo, Kunihiro, Osoreda, Hisayuki, Ishimatsu, Akiko, Taguchi, Kazuhito, Moriwaki, Atsushi, Wakamatsu, Kentaro, Iwanaga, Tomoaki, Yoshida, Makoto
• Format: Article
• Language: English
• Subjects: Acute exacerbation; Interstitial pneumonia; Rheumatoid arthritis; Risk factor
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2022.106898

Several studies have reported that acute exacerbation (AE), which occurs during the clinical course of idiopathic pulmonary fibrosis (IPF), also occurs in rheumatoid arthritis–associated interstitial lung disease (RA-ILD). However, the incidence, clinical features, and risk factors for AE, a major cause of death of RA-ILD patients, and the differences in clinical aspects of AE between RA-ILD and IPF have yet to be fully understood. We retrospectively reviewed data on 149 RA-ILD patients and 305 IPF patients. We investigated the frequency of AE and compared the clinical data between RA-ILD with and without AE to clarify the risk factor for AE. We also compared the post-AE prognosis and cause of death between RA-ILD and IPF patients. Twenty-seven (18.1%) RA-ILD patients and 84 (27.5%) IPF patients developed AE. The median survival time (MST) after AE of RA-ILD and IPF was 277 days and 60 days, respectively (log rank, p = 0.038). In a multivariate analysis, hypoalbuminemia [odds ratio (O.R.) 0.090 (95%CI 0.011–0.733), p = 0.012] and % carbon monoxide diffusion capacity (%DLCO) [O.R. 0.810 (95%CI 0.814–0.964), p