Pulmonary Manifestations in Early Rheumatoid Arthritis: A 6 Month Follow up Study

Gudrun Reynisdottir¹, Helga Olsen², Johan Grunewald², Magnus Skold², Anders Eklund³ and Anca I Catrina⁴, ¹Rheumatology Unit, Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden, ²Department of Medicine, Division of Respiratory Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden, ³Division of Respiratory Medicine, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden, ⁴Unit of Rheumatology, Department of Medicine Solna, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Lung Disease and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 9, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster II

Session Type: ACR Poster Session B

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

Background/Purpose:

Pulmonary manifestations are common in rheumatoid arthritis (RA). However, limited information is available concerning the early development of such manifestations in newly diagnosed patients. In this study we present the six months follow up data of a previously published study, documenting the pulmonary response to standard disease modifying anti rheumatic drug (DMARD) treatment in patients with early RA.

Methods:

A total of 143 patients with newly diagnosed RA were recruited via the Early Arthritis Clinic (Karolinska University Hospital in Stockholm, Sweden). Patient characteristics were recorded at baseline, and high resolution computed tomography (HRCT) and spirometry were performed at inclusion and after six months of treatment.

Results: HRCT at baseline demonstrated parenchymal abnormalities in 54% of patients and/or airway changes in 66% of patients. Pulmonary fibrosis was evident in twelve patients. At 6 months follow up, no obvious changes were observed with the exception of radiographic progression of pulmonary fibrosis in one third of patients (four of 12 patients). Furthermore, an additional three patients developed new radiographic changes suggestive of early interstitial lung disease. Spirometry was abnormal in 62% of patients at inclusion, with a reduced DLco and/or airways obstruction being the most common findings (occurring in 52% and 32%, respectively). At follow up, the forced expiratory volume in one second (FEV1) had decreased by a mean of 70 ml in all patients. The reduction was numerically larger in current smokers compared to never smokers (150 ml versus 30 ml), but was independent of antibody status.

Conclusion:

RA patients frequently exhibit pulmonary HRCT changes and signs of airway inflammation, already at the early stages of the disease, not obviously related to methotrexate treatment and smoking. Pre-clinical interstitial lung disease (ILD) is prevalent and may be progressive.

Disclosure: G. Reynisdottir, None; H. Olsen, None; J. Grunewald, None; M. Skold, None; A. Eklund, None; A. I. Catrina, None.

To cite this abstract in AMA style:

Reynisdottir G, Olsen H, Grunewald J, Skold M, Eklund A, Catrina AI. Pulmonary Manifestations in Early Rheumatoid Arthritis: A 6 Month Follow up Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/pulmonary-manifestations-in-early-rheumatoid-arthritis-a-6-month-follow-up-study/. Accessed .

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