Prevalence of Subclinical Interstitial Lung Disease After a Mean Rheumatoid Arthritis Duration of 13 Years: Results from the French ESPOIR Cohort

Pierre-Antoine Juge¹, Marie-Pierre Debray², Esther Ebstein¹, Raphaël Borie³, Arnaud Constantin⁴, Bernard Combe⁵, Bruno Fautrel⁶, Rene-Marc Flipo⁷, Xavier Mariette⁸, Olivier Vittecoq⁹, Alain Saraux¹⁰, Guillermo Carvajal Alegria¹¹, Jean Sibilia¹², Francis Berenbaum¹³, Bruno Crestani³ and Philippe Dieude¹⁴, ¹Université de Paris, Service de Rhumatologie Hôpital Bichat-Claude Bernard, AP-HP, Paris, France, ²Université de Paris, Service de Radiologie Hôpital Bichat-Claude Bernard, AP-HP, Paris, France, ³Université de Paris, Service de Pneumologie Hôpital Bichat-Claude Bernard, AP-HP, Paris, France, ⁴Hospital Pierre Paul Riquet, Toulouse, France, ⁵University of Montpellier, Montpellier, France, ⁶Sorbonne University, INSERM, IPLES; Pitié-Salpêtrière Hospital, Paris, Ile-de-France, France, ⁷Lille University Hospital, Lille, France, ⁸Paris-Sud University, Rueil-Malmaison, France, ⁹University Hospital of Rouen, Rouen, France, ¹⁰Department of Rheumatology, UBO, CHU, INSERM 1227 (LBAI), Brest, France, ¹¹CHU de Brest, Service de Rhumatologie, Brest, France, ¹²Department of rheumatology, University Hospitals of Strasbourg and French National Reference Center for Rare Auto-immune diseases, Strasbourg, France, ¹³AP-HP, Hôpital Saint-Antoine, Service de Rhumatologie, Centre de Recherche Saint-Antoine, INSERM UMR_S 938,Sorbonne Université, Paris, 75012, France, Paris, France, ¹⁴Université de Paris, Service de Rhumatologie Hôpital Bichat-Claude Bernard, AP-HP, Paris, Ile-de-France, France

Meeting: ACR Convergence 2020

Keywords: interstitial lung disease, rheumatoid arthritis

Session Information

Date: Sunday, November 8, 2020

Title: RA – Diagnosis, Manifestations, & Outcomes Poster III: Cardiopulmonary Aspects

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Interstitial lung disease (ILD) is a frequent extra-articular manifestation of rheumatoid arthritis (RA). It is associated with a high morbi-mortality. However, the exact prevalence of clinical and subclinical RA-ILD is still unknown as it largely varies between studies, depending on the screening tool and the temporality of the screening. Using a systematic detection by high-resolution computed-tomography (HRCT) chest scan, subclinical ILD has been reported in 20 to 60% of patients with RA. Our objective was to estimate the prevalence of clinical and subclinical ILD in the ESPOIR cohort after 13 years of RA duration.

Methods: In this cross-sectional study of the ESPOIR cohort, a HRCT chest scan was systematically proposed to the patients after a mean RA duration of 13 years. The ESPOIR cohort included patients aged 18 to 70 years who had a definitive or probable diagnosis of RA and included a prospective follow-up. HRCT scans were centrally reviewed by an expert radiologist. ILD presence, extension and characteristics were assessed using the current recommendations for ILD assessment (Raghu et al, Am J Respir Crit Care Med, 2011). To note, 2 patients had previously died from clinical ILD and were not included in this analysis.

Results: Within the ESPOIR Cohort, 493 patients had a 10 or more years of follow-up. 175 patients were assessed by HRCT scan. 170 patients (133 women (78.2%), mean age (61.1 ±10.3 y/o), mean RA duration (13.7 ±1.1 years)) had an interpretable HRCT scans and were included in the analysis. Among them, chest HRCT scan identified subclinical ILD in 31 patients (18.2%): 19 women (61.3%), mean age 67.9 ±8.7 y/o, mean age at RA onset 54.3 ±8.6 y/o. Seventeen patients (54.9%) had a smoking history. Subclinical ILD with a HRCT extension of < 5%, 5-10% and >10% was observed in: 7 (4.1%), 15 (8.8%) and 9 patients (5.3%), respectively. Among the 9 patients with a HRCT extent >10%, 4 had a definite or probable usual interstitial pneumonia pattern, 3 patients had a non-specific interstitial pneumonia pattern and 2 had indeterminate patterns.

Conclusion: In the French ESPOIR Cohort, the prevalence of subclinical ILD after a mean RA duration of 13 years was 18.2%, illustrating that the occurrence of ILD is not a rare event.

Disclosure: P. Juge, Bristol-Myers Squibb Company, 5; M. Debray, None; E. Ebstein, None; R. Borie, None; A. Constantin, AbbVie Inc., 5, 8, Amgen, 5, 8, Celltrion, 5, Gilead, 5, 8, Eli Lilly and Company, 5, 8, Novartis, 5, 8, Pfizer Inc., 5, 8, UCB, 5, 8, Janssen, 8; B. Combe, AbbVie, 5, 8, Janssen, 5, Eli Lilly, 2, 5, 8, Novartis, 2, Gilead Sciences, Inc., 5, 8, Roche-Chugai, 5, 8, Sanofi, 5, Pfizer, 2, 8, MSD, 8, Bristol-Myers Squibb, 8; B. Fautrel, MSD France, 1, 2, Abbvie, 1, 2, Pfizer, 1, 2, Biogen, 1, BMS, 1, Boehringer Ingelheim, 1, Celgene, 1, Janssen, 1, Lilly, 1, Medac, 1, Nordic Pharma, 1, Novartis, 1, Roche, 1, Sanofi-Aventis, 1, SOBI, 1, UCB Pharma, 1; R. Flipo, MSD France, 1, 2, Sanofi-Aventis, 1; X. Mariette, None; O. Vittecoq, BMS, 5, Novartis, 8, Pfizer, 8, ABBVIE, 5, 8; A. Saraux, AbbVie, 5, 8, Bristol-Myers Squibb, 5, 8, Chugai, 5, 8, Eli Lilly, 5, 8, Nordic, 5, 8, Sanofi, 5, 8, UCB Pharma, 5, 8; G. Carvajal Alegria, None; J. Sibilia, Roche-Chugaï, 8, BMS, 8, UCB, 8, GSK, 8, LFB, 8, Actelion, 8, Pfizer, 8, MSD, 8, Novartis, 8, Amgen, 8, Abbvie, 8, Sandoz, 8, Gilead, 8, Lilly, 8, Sanofi, 8, Janssen, 8, Mylan, 8; F. Berenbaum, Pfizer, 1, Eli Lilly, 1; B. Crestani, None; P. Dieude, None.

To cite this abstract in AMA style:

Juge P, Debray M, Ebstein E, Borie R, Constantin A, Combe B, Fautrel B, Flipo R, Mariette X, Vittecoq O, Saraux A, Carvajal Alegria G, Sibilia J, Berenbaum F, Crestani B, Dieude P. Prevalence of Subclinical Interstitial Lung Disease After a Mean Rheumatoid Arthritis Duration of 13 Years: Results from the French ESPOIR Cohort [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/prevalence-of-subclinical-interstitial-lung-disease-after-a-mean-rheumatoid-arthritis-duration-of-13-years-results-from-the-french-espoir-cohort/. Accessed .

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