Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients...

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Detalles Bibliográficos
Autores: Cano-Jiménez, Esteban, Vázquez Rodríguez, Tomás|||0000-0001-6718-5044, Martín-Robles, Irene, Castillo, Diego|||0000-0002-4862-3595, Juan García, Javier, Bollo de Miguel, Elena, Robles-Pérez, Alejandro, Ferrer Galván, Marta, Mouronte Roibas, Cecilia, Herrera Lara, Susana, Bermudo, Guadalupe|||0000-0002-2010-7679, García Moyano, Marta, Rodríguez Portal, Jose Antonio, Sellarés Torres, Jacobo, Narváez, Javier|||0000-0002-1614-8064, Molina Molina, Maria|||0000-0002-1852-1723
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:271993
Acceso en línea:https://ddd.uab.cat/record/271993
https://dx.doi.org/urn:doi:10.1038/s41598-021-88734-2
Access Level:acceso abierto
Palabra clave:Adult
Aged
Aged, 80 and over
Antirheumatic Agents
Arthritis, Rheumatoid
Cross-Sectional Studies
Delayed Diagnosis
Female
Humans
Leflunomide
Lung Diseases, Interstitial
Male
Methotrexate
Middle Aged
Respiratory Tract Infections
Spain
Descripción
Sumario:Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01-1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09-1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73-0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39-0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59-13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03-1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14-4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.

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