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Interstitial Lung Disease in Rheumatoid Arthritis Remains a Challenge for Clinicians

Author

Bendstrup E1, Møller J1, Kronborg-White S1, Prior TS1, Hyldgaard C2. J Clin Med. 2019 Nov 21;8(12). pii: E2038. doi: 10.3390/jcm8122038.

Author Information

1 Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark.

2 Regional Hospital, Falkevej 1-3, 8600 Silkeborg, Denmark.

Abstract

Interstitial lung disease (ILD) is a serious complication of rheumatoid arthritis (RA) contributing to significantly increased morbidity and mortality. Other respiratory complications, such as chronic obstructive pulmonary disease and bronchiectasis, are frequent in RA. Infections and drug toxicity are important differential diagnoses and should be considered in the diagnostic work-up of patients with RA presenting with respiratory symptoms. This review provides an overview of the epidemiology and pathogenesis of RA-ILD, the radiological and histopathological characteristics of the disease as well as the current and future treatment options. Currently, there is no available evidence-based therapy for RA-ILD, and immunosuppressants are the mainstay of therapy. Ongoing studies are exploring the role of antifibrotic therapy in patients with progressive fibrotic ILD, which may lead to a new treatment approach for subgroups of patients with RA-ILD.