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Abstract：
OBJECTIVE: Interstitial lung disease (ILD) in rheumatoid arthritis (RA) is a serious complication with varied prevalence ranging from 4% to as high as 68%, with varied presentation. Immunosuppressants and antifibrotics are used in the management of RA ILD. The clinicodemographic profile and presentation in our country need to be further explored. We assessed the efficacy and safety profile of antifibrotic drugs in combination with immunosuppressants among RA ILD patients.
METHODS: A prospective observational study was conducted in the Interstitial Lung Disease (ILD) Clinic in the Department of Pulmonary Medicine, All India Institute of Medical Sciences Raipur, India, between January 2022 to January 2023. RA patients with dyspnea and chronic cough were referred to us for evaluation of ILD. Patients underwent clinical examination, complete lung function study including spirometry, single breath diffusion capacity for carbon monoxide (DLCO), six-minute walk test, and high-resolution computed tomography of the thorax. Quality of life was assessed using the King\'s Brief Interstitial Lung Disease (KBILD) questionnaire.
RESULTS: Two hundred eighteen RA patients were evaluated and out of these, 43 (20.8%) had features of ILD on high-resolution computed tomogram (HRCT) thorax. Twenty-six (2.18%) met the inclusion criteria for starting antifibrotics. The mean ± SD. age of the patients was 52.96 ± 14.04 and the majority (77%) were females. Fourteen (53.38%) patients had usual interstitial pneumonia (UIP)/probable UIP pattern and 12 (46.22%) had nonspecific interstitial pneumonia (NSIP) patterns on HRCT. Out of 26 patients, 24 (92.3%) were started on antifibrotics. Fourteen (53.8%) patients were on nintedanib and 10 (38.4%) were on pirfenidone. The mean ± SD forced vital capacity (FVC)% predictedwas 62.5 ± 20.04. The mean ± SD. The DLCO percentage predicted was 54.4 ± 22.8. Twenty-two (84.6%) patients did not experience any side effects. The mean ± SD. KBILD score was 59.9 ± 11.17 and was similar in both sexes.
CONCLUSIONS: In our study, the prevalence of RA ILD was nearly 20.8% and more common in females. Twenty-four (2%) patients were included for antifibrotic treatment. There was an improvement in lung function at the end of six months, but the change was not significant. All patients tolerated antifibrotics well without any serious adverse events.
METHODS: A prospective observational study was conducted in the Interstitial Lung Disease (ILD) Clinic in the Department of Pulmonary Medicine, All India Institute of Medical Sciences Raipur, India, between January 2022 to January 2023. RA patients with dyspnea and chronic cough were referred to us for evaluation of ILD. Patients underwent clinical examination, complete lung function study including spirometry, single breath diffusion capacity for carbon monoxide (DLCO), six-minute walk test, and high-resolution computed tomography of the thorax. Quality of life was assessed using the King\'s Brief Interstitial Lung Disease (KBILD) questionnaire.
RESULTS: Two hundred eighteen RA patients were evaluated and out of these, 43 (20.8%) had features of ILD on high-resolution computed tomogram (HRCT) thorax. Twenty-six (2.18%) met the inclusion criteria for starting antifibrotics. The mean ± SD. age of the patients was 52.96 ± 14.04 and the majority (77%) were females. Fourteen (53.38%) patients had usual interstitial pneumonia (UIP)/probable UIP pattern and 12 (46.22%) had nonspecific interstitial pneumonia (NSIP) patterns on HRCT. Out of 26 patients, 24 (92.3%) were started on antifibrotics. Fourteen (53.8%) patients were on nintedanib and 10 (38.4%) were on pirfenidone. The mean ± SD forced vital capacity (FVC)% predictedwas 62.5 ± 20.04. The mean ± SD. The DLCO percentage predicted was 54.4 ± 22.8. Twenty-two (84.6%) patients did not experience any side effects. The mean ± SD. KBILD score was 59.9 ± 11.17 and was similar in both sexes.
CONCLUSIONS: In our study, the prevalence of RA ILD was nearly 20.8% and more common in females. Twenty-four (2%) patients were included for antifibrotic treatment. There was an improvement in lung function at the end of six months, but the change was not significant. All patients tolerated antifibrotics well without any serious adverse events.
摘要：
目的：类风湿性关节炎（RA）的间质性肺病（ILD）是一种严重的并发症，患病率从4％到高达68％不等。不同的介绍。免疫抑制剂和抗纤维化药物用于治疗RAILD。我国的临床人口统计学特征和表现有待进一步探讨。我们评估了抗纤维化药物联合免疫抑制剂在RAILD患者中的疗效和安全性。
方法：在肺内科的间质性肺病（ILD）诊所进行了一项前瞻性观察性研究，全印度医学科学研究所Raipur,印度,2022年1月至2023年1月。患有呼吸困难和慢性咳嗽的RA患者被转介给我们以评估ILD。患者接受临床检查，完整的肺功能研究，包括肺活量测定，一氧化碳（DLCO）的单次呼吸扩散能力，六分钟步行测试,和高分辨率的胸部计算机断层扫描。使用King短暂间质性肺病（KBILD）问卷评估生活质量。
结果：对118例RA患者进行了评估，其中，43（20.8％）在高分辨率计算机断层扫描（HRCT）胸部具有ILD特征。二十六（2.18％）符合起始抗纤维化药物的纳入标准。平均值±SD。患者的年龄为52.96±14.04，大多数（77％）为女性。14例（53.38％）患者在HRCT上有常规间质性肺炎（UIP）/可能的UIP模式，12例（46.22％）有非特异性间质性肺炎（NSIP）模式。在26名患者中，24（92.3%）开始服用抗纤维化药。14例（53.8％）患者使用尼达尼布，10例（38.4％）使用吡非尼酮。预测的平均±SD强迫肺活量（FVC）％为62.5±20.04。平均值±SD。预测的DLCO百分比为54.4±22.8。22例（84.6%）患者未出现任何副作用。平均值±SD。KBILD得分为59.9±11.17，男女相似。
结论：在我们的研究中，RAILD的患病率接近20.8%,在女性中更为常见.24（2％）患者被纳入抗纤维化治疗。六个月后肺功能有所改善，但变化并不显著。所有患者均耐受抗纤维化药物，无任何严重不良事件。
方法：在肺内科的间质性肺病（ILD）诊所进行了一项前瞻性观察性研究，全印度医学科学研究所Raipur,印度,2022年1月至2023年1月。患有呼吸困难和慢性咳嗽的RA患者被转介给我们以评估ILD。患者接受临床检查，完整的肺功能研究，包括肺活量测定，一氧化碳（DLCO）的单次呼吸扩散能力，六分钟步行测试,和高分辨率的胸部计算机断层扫描。使用King短暂间质性肺病（KBILD）问卷评估生活质量。
结果：对118例RA患者进行了评估，其中，43（20.8％）在高分辨率计算机断层扫描（HRCT）胸部具有ILD特征。二十六（2.18％）符合起始抗纤维化药物的纳入标准。平均值±SD。患者的年龄为52.96±14.04，大多数（77％）为女性。14例（53.38％）患者在HRCT上有常规间质性肺炎（UIP）/可能的UIP模式，12例（46.22％）有非特异性间质性肺炎（NSIP）模式。在26名患者中，24（92.3%）开始服用抗纤维化药。14例（53.8％）患者使用尼达尼布，10例（38.4％）使用吡非尼酮。预测的平均±SD强迫肺活量（FVC）％为62.5±20.04。平均值±SD。预测的DLCO百分比为54.4±22.8。22例（84.6%）患者未出现任何副作用。平均值±SD。KBILD得分为59.9±11.17，男女相似。
结论：在我们的研究中，RAILD的患病率接近20.8%,在女性中更为常见.24（2％）患者被纳入抗纤维化治疗。六个月后肺功能有所改善，但变化并不显著。所有患者均耐受抗纤维化药物，无任何严重不良事件。
