Assessing Mortality in Rheumatoid Arthritis-Related Interstitial Lung Disease

Rheumatoid arthritis-related interstitial lung disease (RA-ILD) is associated with higher-than-average mortality, and the mortality risk is increased by usual interstitial pneumonia (UIP), according to study results recently published in BMC Pulmonary Medicine.

Researchers in Madrid conducted a longitudinal, multicenter study to assess the mortality rate and standardized mortality rates of RA-ILD as well as the association between mortality and radiographic patterns. From 2005 to 2015, with follow up continuing into 2018, investigators studied 47 patients with ILD from the Neumologia-Reumatología y Enfermedades Autoinmunes Registry.

The mortality rate during the study period was 64.3%, with 16 (34%) deaths occurring. The overall standardized mortality rate was 2.57, with women 60 to 75 years of age having the highest standardized mortality rate. Notably, mortality among patients with RA-ILD was significantly higher than in the general population of Madrid, where the study was conducted. The most frequent causes of death were acute ILD exacerbation and pneumonia.

RA-ILD radiographic patterns at baseline were also analyzed. After adjusting for confounding socioeconomic and clinical factors, the UIP radiographic pattern was associated with a higher risk of mortality compared with the nonspecific interstitial pneumonia radiographic pattern. UIP was also associated with higher mortality risk than nonspecific interstitial pneumonia.

Acknowledging that the study was limited by its retrospective nature and sample size, the researchers stated, “Our results support that UIP increases the risk of mortality in RA-ILD, regardless other factors.”

Reference

Nieto MA, Rodriguez‑Nieto MJ, Sanchez‑Pernaute O, et al. Mortality rate in rheumatoid arthritis-related interstitial lung disease: the role of radiographic patterns. BMC Pulm Med. 2021;21:205. doi:10.1186/s12890-021-01569-5