In UK patients with rheumatoid arthritis (RA), lung disease-related mortality reaches 8 per cent, but rituximab shows promising results for the treatment of RA-related interstitial lung disease (ILD), according to research from University College London (UCL).
The retrospective study used data from all patients with RA attending the Rheumatology Department at UCL Hospital from 2002 to March 2018. Patients with RA who had undergone high resolution CT scans of the lung were identified and their scans were reviewed. Demographic data, RA features, complementary exams and treatments were recorded for those with radiological evidence of lung involvement.
The study found that lung disease was reported in 87 (7.7%) of 1129 patients with RA. ILD was the most common pattern, reported in 45 (51.7%) patients. Drug-induced lung disease was reported in two of 64 (3.1%) patients treated with methotrexate.
Rituximab was used in 26 (57.8%) patients with ILD. In an unexpected finding, there was evidence of disease improvement or stabilisation in patients with non-specific interstitial pneumonia and organising pneumonia.
During lung disease follow-up (6.7±4.1 years), 22 (25.3%) patients were admitted to hospital with respiratory infections, with 14 (63.6%) of them having underlying bronchiectasis.
The authors say the findings “raise important issues for clinical practice, such as the use of rituximab in RA-ILD and prophylactic antibiotics in patients with recurrent chest infections”.