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rheumatoid arthritis related lung disease

Yuhei Ito, Machiko Arita, Shogo Kumagai, Reoto Takei, Maki Noyama, Fumiaki Tokioka, Keisuke Nishimura, Takashi Koyama, Hiromasa Tachibana, Tadashi Ishida
Objectives High-resolution computed tomography (HRCT) parenchymal patterns have been used to predict prognosis in patients with interstitial lung disease (ILD). In idiopathic pulmonary fibrosis, the fibrosis score (i.e., the combined extent of reticulation and honeycombing) has been associated with worse survival. This study aimed to identify HRCT patterns and patient characteristics that can predict poor prognosis in rheumatoid arthritis-related ILD (RA-ILD). Methods We retrospectively analysed 65 patients with newly diagnosed RA-ILD from 2007 to 2016 at Kurashiki Central hospital...
February 15, 2018: Modern Rheumatology
Carlos Fernández-Díaz, Javier Loricera, Santos Castañeda, Raquel López-Mejías, Clara Ojeda-García, Alejandro Olivé, Samantha Rodríguez-Muguruza, Patricia E Carreira, Trinidad Pérez-Sandoval, Miriam Retuerto, Evelin C Cervantes-Pérez, Bryan J Flores-Robles, Blanca Hernández-Cruz, Ana Urruticoechea, Olga Maíz-Alonso, Luis Arboleya, Gema Bonilla, Íñigo Hernández-Rodríguez, Desirée Palma, Concepción Delgado, Rosa Expósito-Molinero, Ana Ruibal-Escribano, Belén Álvarez-Rodríguez, Juan Blanco-Madrigal, José A Bernal, Paloma Vela-Casasempere, Manuel Rodríguez-Gómez, Concepción Fito, Francisco Ortiz-Sanjuán, Javier Narváez, Manuel Moreno, Mireia López-Corbeto, Natalia Mena-Vázquez, Clara Aguilera-Cros, Susana Romero-Yuste, Sergi Ordóñez, Ignacio Villa-Blanco, M Carmen Gonzélez-Vela, Víctor Mora-Cuesta, Natalia Palmou-Fontana, José L Hernández, Miguel A González-Gay, Ricardo Blanco
OBJECTIVE: Interstitial lung disease (ILD) is one of the most serious complications of rheumatoid arthritis (RA). In the present study, we aimed to assess the efficacy of abatacept (ABA) in patients with ILD associated to RA. METHODS: National multicenter, non-controlled, open-label registry study of RA patients with ILD treated with ABA. RESULTS: 63 patients (36 women) with RA-associated ILD undergoing ABA therapy were studied. The mean ± standard deviation age at the time of the study was 63...
January 6, 2018: Seminars in Arthritis and Rheumatism
Joseph Jacob, Jin Woo Song, Hee-Young Yoon, Gary Cross, Joseph Barnett, Wen Ling Woo, Fern Adams, Maria Kokosi, Anand Devaraj, Elisabetta Renzoni, Toby M Maher, Dong Soon Kim, Athol U Wells
AIMS: Autoimmune conditions such as rheumatoid arthritis-related interstitial lung disease (RA-ILD) have been linked to the existence of emphysema in never-smokers. We aimed to quantify emphysema prevalence in RA-ILD never-smokers and investigate whether combined pulmonary fibrosis and emphysema (CPFE) results in a worsened prognosis independent of baseline disease extent. METHODS: RA-ILD patients presenting to the Royal Brompton Hospital (n=90) and Asan Medical Center (n=155) had CT's evaluated for a definite usual interstitial pneumonia (UIP) pattern, and visual extents of emphysema and ILD...
January 31, 2018: EBioMedicine
Hanna M Nurmi, Hannu-Pekka Kettunen, Sanna-Katja Suoranta, Minna K Purokivi, Miia S Kärkkäinen, Tuomas A Selander, Riitta L Kaarteenaho
OBJECTIVE: To compare the presence and extent of several high-resolution computed tomography (HRCT) observations in different subtypes of rheumatoid arthritis-related interstitial lung disease (RA-ILD) and to examine associations between radiological findings, hospitalization, age, RA duration, pulmonary function tests (PFT) and survival. MATERIALS AND METHODS: HRCTs from 60 RA-ILD patients were independently evaluated and re-categorized into usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), organizing pneumonia (OP), diffuse alveolar damage (DAD) and unclassified subtypes by two radiologists...
January 2018: Respiratory Medicine
A Heraudeau, C Ricordel, A Sale, M Lederlin, M Kerjouan, B De Latour, F Llamas-Guttierez, B Desrues, S Jouneau
INTRODUCTION: Pancreatic cancer is often not diagnosed until at a metastatic stage at which point the prognosis is very poor. Pulmonary metastases are pleomorphic, often present at the time of diagnosis and can lead to the discovery of an asymptomatic primary disease. CASE REPORT: We describe two cases aged 60 and 74 years, where imaging identified what was thought to be an interstitial lung disease but which was actually metastasis from pancreatic cancer. In the first case, CT showed multiple excavated pulmonary nodules but the presentation with medullary compression led rapidly to pathological diagnosis on bone lesions...
February 1, 2018: Revue des Maladies Respiratoires
François-Xavier Danlos, Anne-Laure Voisin, Valérie Dyevre, Jean-Marie Michot, Emilie Routier, Laurent Taillade, Stéphane Champiat, Sandrine Aspeslagh, Julien Haroche, Laurence Albiges, Christophe Massard, Nicolas Girard, Stéphane Dalle, Benjamin Besse, Salim Laghouati, Jean-Charles Soria, Christine Mateus, Caroline Robert, Emilie Lanoy, Aurélien Marabelle, Olivier Lambotte
OBJECTIVE: Patients with autoimmune or inflammatory disease (AID) are susceptible to immune-related adverse events (irAEs) when treated with immune check-point inhibitors (ICIs). We decided to analyse the safety and effectiveness of anti-PD-1 antibodies in AID patients and look for an association between the presence of pre-existing AID and the clinical outcome. METHODS: In a prospective study of the REISAMIC registry of grade ≥2 irAEs occurring in ICI-treated patients, we studied the associations between pre-existing AID on one hand and irAE-free survival, overall survival and best objective response rate on the other...
March 2018: European Journal of Cancer
Hayley Barnes, Anne E Holland, Glen P Westall, Nicole Sl Goh, Ian N Glaspole
BACKGROUND: Approximately one-third of individuals with interstitial lung disease (ILD) have associated connective tissue disease (CTD). The connective tissue disorders most commonly associated with ILD include scleroderma/systemic sclerosis (SSc), rheumatoid arthritis, polymyositis/dermatomyositis, and Sjögren's syndrome. Although many people with CTD-ILD do not develop progressive lung disease, a significant proportion do progress, leading to reduced physical function, decreased quality of life, and death...
January 3, 2018: Cochrane Database of Systematic Reviews
Peta Pentony, Laurence Duquenne, Katherine Dutton, Kulveer Mankia, Hanna Gul, Edward Vital, Paul Emery
It is well established that the autoantibodies that characterize both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are present systemically years before patients develop disease. In both these autoimmune rheumatic diseases, evidence is growing that local autoimmune processes occur at epithelial surfaces potentially initiating localized autoimmunity. For RA, these are mucosal surfaces including the oral mucosa, lung, and gut. At the oral mucosa and lung, risk factors such as periodontal disease and smoking may contribute to autoimmunity by driving the local generation of citrullinated autoantigens...
November 2017: Discovery Medicine
Michael Dougan
Monoclonal antibodies targeting the regulatory immune "checkpoint" receptors CTLA-4, PD-1, and PD-L1 are now standard therapy for diverse malignancies including melanoma, lung cancer, and renal cell carcinoma. Although effective in many patients and able to induce cures in some, targeting these regulatory pathways has led to a new class of immune-related adverse events. In many respects, these immune toxicities resemble idiopathic autoimmune diseases, such as inflammatory bowel disease, autoimmune hepatitis, rheumatoid arthritis, and vitiligo...
2017: Frontiers in Immunology
Ida Kristiane Roelsgaard, Thordis Thomsen, Mikkel Østergaard, Robin Christensen, Merete Lund Hetland, Søren Jacobsen, Lena Andersen, Hanne Tønnesen, Silvia Rollefstad, Anne Grete Semb, Bente Appel Esbensen
BACKGROUND: Rheumatoid arthritis (RA) is a chronic, inflammatory rheumatic disease with the potential to induce significant disability. Patients with RA are at increased risk of cardiovascular diseases (CVD). Smokers with RA tend to experience more pain and fatigue, higher disease activity, more erosive joint destruction and a lower health-related quality of life (HR-QoL) than non-smokers. It remains to be determined whether these effects can be reduced by smoking cessation. This randomised controlled trial (RCT) in patients with RA aims to examine the effect of intensive smoking cessation intervention (motivational counselling combined with tailored nicotine replacement therapy) versus standard care on smoking cessation, and consequently on disease activity...
November 28, 2017: Trials
Atsushi Hashimoto, Shiori Suto, Kouichiro Horie, Hidefumi Fukuda, Shinichi Nogi, Kanako Iwata, Hirotaka Tsuno, Hideki Ogihara, Misato Kawakami, Akiko Komiya, Hiroshi Furukawa, Toshihiro Matsui, Shigeto Tohma
Objective: Rheumatoid arthritis (RA) may be complicated by different infections, but risk factors for these are not fully elucidated. Here, we assessed the incidence of and risk factors for infections requiring hospitalization (IRH) including pneumocystis pneumonia (PCP) in patients with RA. Methods: We retrospectively surveyed all RA patients treated at our hospital from 2009 to 2013, for whom data were available on demographic features, medications, comorbidities, and severity of RA...
2017: International Journal of Rheumatology
C Pierce Bradley, Fei Teng, Krysta M Felix, Teruyuki Sano, Debdut Naskar, Katharine E Block, Haochu Huang, Kenneth S Knox, Dan R Littman, Hsin-Jung Joyce Wu
Lung complications are a major cause of rheumatoid arthritis-related mortality. Involvement of gut microbiota in lung diseases by the gut-lung axis has been widely observed, but the underlying mechanism remains mostly unknown. Using an autoimmune arthritis model, we show that a constituent of the gut microbiota, segmented filamentous bacteria (SFB), distantly provoke lung pathology. SFB induce autoantibodies in lung during the pre-arthritic phase, and SFB-dependent lung pathology requires the T helper 17 (Th17) responses...
November 8, 2017: Cell Host & Microbe
Alper Toker, Mehmet Oğuzhan Özyurtkan, Erkan Kaba
Nodal upstaging after surgical intervention for non-small cell lung cancer (NSCLC) is defined as the presence of unsuspected pathologic hilar (pN1) or mediastinal (pN2) disease detected during the final histopathologic evaluation of surgical specimens. The prevalence of pathologic nodal upstaging is used as a quality measure for the definition of the completeness of the nodal dissection. Risk factors for nodal upstaging may be patient-related (history of tuberculosis, rheumatoid arthritis, and diabetes mellitus), or tumor-related (central tumor, higher T stage, higher SUVmax value, or adenocarcinoma)...
2017: Journal of Visualized Surgery
Francisco Paulin, Alejandra Babini, Marta Mamani, Juan Mercado, Fabián Caro
The prevalence of interstitial lung disease in patients with rheumatoid arthritis varies from 10 to 42%. Rheumatoid arthritis patients with interstitial lung disease have three times the risk of death compared with those without the disease. Prognosis seems to be related to the high-resolution computed tomography pattern. Usual interstitial pneumonia pattern, resembling idiopathic pulmonary fibrosis, carries a worse prognosis. Validated strategies to identify different phenotypes and assess the disease activity in rheumatoid arthritis interstitial lung disease are lacking...
September 2017: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
Hamza Jawad, Sebastian R McWilliams, Sanjeev Bhalla
PURPOSE OF REVIEW: The study aimed to illustrate the cardiopulmonary findings of the following collagen vascular diseases on cross-sectional imaging: rheumatoid arthritis, scleroderma (progressive systemic sclerosis), systemic lupus erythematosus, the inflammatory myopathies (polymyositis/dermatomyositis), and Sjögren's syndrome. RECENT FINDINGS: Although collagen vascular diseases can affect any part of the body, interstitial lung disease and pulmonary hypertension are the two most important cardiopulmonary complications and are responsible for the majority of morbidity and mortality in this patient population...
October 9, 2017: Current Rheumatology Reports
Dan Murphy, David Hutchinson
BACKGROUND: Rheumatoid arthritis (RA) is a systemic, inflammatory disease with an estimated global prevalence of 0.3-1.0%. An unexplained association exists between low formal education and the development of RA independent of smoking. It is established that RA is initiated in the lungs and that various occupations associated with dust, fume and metal inhalation can increase the risk of RA development. OBJECTIVE: The objective of this review is to evaluate published clinical reports related to occupations associated with RA development...
2017: Open Rheumatology Journal
Dewan Md Emdadul Hoque, Varuni Kumari, Masuma Hoque, Rasa Ruseckaite, Lorena Romero, Sue M Evans
BACKGROUND: Clinical quality registries (CQRs) are playing an increasingly important role in improving health outcomes and reducing health care costs. CQRs are established with the purpose of monitoring quality of care, providing feedback, benchmarking performance, describing pattern of treatment, reducing variation and as a tool for conducting research. OBJECTIVES: To synthesise the impact of clinical quality registries (CQRs) as an 'intervention' on (I) mortality/survival; (II) measures of outcome that reflect a process or outcome of health care; (III) health care utilisation; and (IV) healthcare-related costs...
2017: PloS One
Hailan Li, Zeng Xiong, Jinkang Liu, Yisha Li, Bin Zhou
To analyze the features of the connective tissue associated interstitial lung disease (CTD-ILD) by high resolution computed tomography (HRCT).
 Methods: A total of 127 patients with CTD-ILD, who were diagnosed by clinic laboratory examination and pathology in Xiangya Hospital of Central South University form September 2013 to September 2015, were enrolled for this study. Their lung features of HRCT imaging were retrospectively analyzed.
 Results: The classifications for 127 patients were as follows: 36 cases of rheumatoid arthritis (28...
August 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
James Bluett, Meghna Jani, Deborah P M Symmons
Lung disease is one of the most common causes of extra-articular morbidity and mortality in patients with rheumatoid arthritis (RA). Development of pulmonary manifestations may be due to the systemic disease itself; to serious respiratory adverse events such as pneumonitis and infections secondary to therapy; or to lifestyle habits such as smoking. Rheumatologists often need to make important treatment decisions and plan future care in RA patients with respiratory comorbidities, despite the absence of clear evidence or consensus...
December 2017: Rheumatology and Therapy
Evangelos A A Christou, Giuliana Giardino, Austen Worth, Fani Ladomenou
Rituximab (RTX) is a monoclonal antibody against CD20, commonly used in the treatment of hematological malignancies and autoimmune diseases. The use of RTX is related to the development of hypogammaglobulinemia and infections. Aim of this review is to summarize the evidence supporting the association of specific risk factors with the development of hypogammaglobulinemia and infections post-RTX. Immunological complications are more common in patients with malignant diseases as compared to non-malignant diseases...
November 2, 2017: International Reviews of Immunology
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