Interstitial lung disease in patients with rheumatoid arthritis

Spontaneous and drug induced

Robert W. Hallowell, Maureen Horton

Research output: Contribution to journalArticle

Abstract

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease characterized by the destruction of articular joint structures. RA is a systemic condition that often affects multiple organs, including the heart, lungs, and kidneys. Pulmonary complications of RA are relatively common and include pleural effusion, rheumatoid nodules, bronchiectasis, obliterative bronchiolitis, and opportunistic infections. Interstitial lung disease (ILD) is a common occurrence in patients with RA, and can range in severity from an asymptomatic incidental finding to a rapidly progressing life-threatening event. Usual interstitial pneumonia and non-specific interstitial pneumonia are the two most common patterns, though others have been reported. Various disease-modifying anti-rheumatic drugs-in particular, methotrexate and the tumor necrosis factor-alpha inhibitors-have been associated with RA-ILD in numerous case reports and case series, though it is often difficult to distinguish association from causality. Treatment for RA-ILD typically involves the use of high-dose corticosteroids, often in conjunction with alternative immunosuppressant agents such as azathioprine or mycophenolate mofetil, and outcomes vary widely depending on the initial pattern of lung disease. Additional research into the mechanisms driving RA-ILD is needed to guide future therapy.

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalDrugs
Volume74
Issue number4
DOIs
StatePublished - 2014

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Interstitial Lung Diseases
Rheumatoid Arthritis
Pharmaceutical Preparations
Joints
Rheumatoid Nodule
Mycophenolic Acid
Lung
Idiopathic Pulmonary Fibrosis
Bronchiolitis
Antirheumatic Agents
Incidental Findings
Bronchiectasis
Opportunistic Infections
Azathioprine
Pleural Effusion
Immunosuppressive Agents
Methotrexate
Causality
Lung Diseases
Autoimmune Diseases

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Medicine(all)

Cite this

Interstitial lung disease in patients with rheumatoid arthritis : Spontaneous and drug induced. / Hallowell, Robert W.; Horton, Maureen.

In: Drugs, Vol. 74, No. 4, 2014, p. 443-450.

Research output: Contribution to journalArticle

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