Session Type: Abstract Submissions (ACR)
Background/Purpose: To describe the association between rheumatoid arthritis disease activity (RA) and interstitial lung damage (inflammation and fibrosis), in a cohort of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) patients.
Methods: A retrospective study of RA patients with interstitial lung disease (restrictive pattern in lung function tests and evidence of interstitial lung disease in high resolution computed tomography (HRCT)). Patients had a complete evaluation to exclude other causes of pulmonary disease. RA disease activity was measured with the CDAI index. Interstitial lung inflammation and fibrosis were determined by Kazerooni scale. We compared Kazerooni ground-glass score with the nearest CDAI score to HRCT date scan. In 18 patients, a bronchoalveolar lavage (BAL) cell profile (lymphocytes cell count, neutrophils cell count and macrophages cell count) was available and was correlated with the nearest CDAI index. In nine patients, we compared the first ground-glass score with a second one after treatment with DMARs and corticosteroids. Spearman’s rank correlation coefficient was used to evaluate the association between RA disease activity with the Kazerooni ground-glass and fibrosis scores, and with the BAL cell profiles.
Results: Thirty-four patients were included. A positive correlation between CDAI and ground-glass scores was found (rs= 0.3767 (P < 0.028). Fibrosis and CDAI scores were not associated (rs= -0.0747, p < 0.6745). In the 18 patients with BAL lavage, lymphocytes cell count correlated strongly with the CDAI index (rs= 0.58, p < 0.011). After treatment, a tendency to lowering in ground-glass score was observed (median [IQR]): (2.33 [2-3] vs. 2 [1.33-2.16]), p<0.056, along with lowering in CDAI score (27 [8-43] vs. 9 [5-12]), p<0.063.
Conclusion: there is a correlation between RA disease activity and ground glass in HRCT in RA-ILD patients. Lymphocytic BAL in RA seems to correlate with disease activity. Ground glass may respond to treatment.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/rheumatoid-arthritis-associated-interstitial-lung-disease-lung-inflammation-evaluated-with-high-resolution-computed-tomography-scan-is-correlated-to-rheumatoid-arthritis-disease-activity/