Journal
EUROPEAN JOURNAL OF INTERNAL MEDICINE
Volume 24, Issue 7, Pages 597-603Publisher
ELSEVIER
DOI: 10.1016/j.ejim.2013.07.004
Keywords
Rheumatoid; Arthritis; Interstitial lung disease; Pulmonary fibrosis
Categories
Funding
- Health Research Board (HRB), Ireland
- Science Foundation Ireland (SFI)
- HRB
- EU IMI
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Rheumatoid Arthritis (RA) is the most common Connective Tissue Disease (CTD) and represents an increasing burden on global health resources. Interstitial lung disease (ILD) has been recognised as a complication of RA but its potential for mortality and morbidity has arguably been under appreciated for decades. New studies have underscored a significant lifetime risk of ILD development in RA. Contemporary work has identified an increased risk of mortality associated with the Usual Interstitial Pneumonia (UIP) pattern which shares similarity with the most devastating of the interstitial pulmonary diseases, namely Idiopathic Pulmonary Fibrosis (IPF). In this paper, we discuss recent studies highlighting the associated increase in mortality in RA-UIP. We explore associations between radiological and histopathological features of RA-ILD and the prognostic implications of same. We emphasise the need for translational research in this area given the growing burden of RA-ILD. We highlight the importance of the respiratory physician as a key stakeholder in the multidisciplinary management of this disorder. RA-ILD focused research offers the opportunity to identify early asymptomatic disease and define the natural history of this extra articular manifestation. This may provide a unique opportunity to define key regulatory fibrotic events driving progressive disease. We also discuss some of the more challenging and novel aspects of therapy for RA-ILD. (C) 2013 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
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