Date: Sunday, November 8, 2020
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.
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 March 1, 2021.
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ACR Meeting Abstracts - 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/