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Prevalence of RA-ILD

Interstitial lung disease (ILD) develops in up to 30% of patients with rheumatoid arthritis (RA)1-5

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RA affects approximately 0.5%–1% of the population worldwide,6–8 and ILD can be found in 10%–30% of all RA patients1–5
Prevalence of RA and RA-ILD per 100,000.

 

Prevalence of RA and RA-ILD per 100,00. Prevalence figures sourced as midpoint values from ranges for RA and RA-ILD prevalence as follows: RA prevalence 500-1000 per 100,000;6–8 RA prevalence 10%-30% of RA.1–3

The reported prevalence of RA-ILD varies widely depending on the characteristics of the population selected as well as the definitions, criteria and tools employed for diagnosis.6,9

pRAILD

Pulmonary complications occur in 60–80% of patients with RA, many of whom are asymptomatic3,10–12
pRAILDKF2

Clinically-evident ILD occurs in up to 10% of RA patients1 and interstitial lung abnormalities (ILAs) are reported to occur in 20%–60% of patients with RA7,13 

Typical patient demographics in RA-ILD:

Male-to-female ratio

Male-to-female ratio
Age

Age
Smoking

Smoking
Serology

Serology

RA-ILD typically occurs in male patients in their 40s to 50s with a history of smoking.4,9 Male RA patients may have a 4-times greater ILD risk than women, although RA is more common in women.3 Patients with RA who are seropositive for RF or anti-CCP antibody are at risk of developing ILD.5,14–18

What impact could ILD have on your patients with RA and how can you identify this threat?
Footnotes
  • CCP, cyclic citrullinated peptide; CTD, connective tissue; CTD-ILD, connective tissue disease-associated interstitial lung disease; ILA, interstitial lung abnormality; ILD, interstitial lung disease; RA; rheumatoid arthritis; RA-ILD, rheumatoid arthritis-associated interstitial lung disease; RF, rheumatoid factor.

  1. Olson AL, Swigris JJ, Sprunger DB, et al. Rheumatoid arthritis-interstitial lung diseaseassociated mortality. Am J Respir Crit Care Med. 2011;183(3):372-378.

  2. Geerts S, Wuyts W, De Langhe E, et al. Connective tissue disease associated interstitial pneumonia: a challenge for both rheumatologists and pulmonologists. Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(4):326–335.

  3. Esposito AJ, Chu SG, Madan R, et al. Thoracic manifestations of rheumatoid arthritis. Clin Chest Med. 2019;40(3):545–560.

  4. Shaw M, Collins BF, Ho LA, Raghu G. Rheumatoid arthritis-associated lung disease. Eur Respir Rev. 2015;24(135):1–16.

  5. Kelly CA, Saravanan V, Nisar M, et al. Rheumatoid arthritis-related interstitial lung disease: associations, prognostic factors and physiological and radiological characteristics – a large multicentre UK study. Rheumatology (Oxford). 2014;53(9):1676–1682.

  6. Assayag D, Lee JS, King Jr TE. Rheumatoid arthritis associated interstitial lung disease: a review. Medicina (B Aires). 2014;74(2):158–165.

  7. Kawano-Dourado L, Doyle TJ, Bonfiglioli K, et al. Baseline characteristics and progression of a spectrum of interstitial lung abnormalities and disease in rheumatoid arthritis. Chest. 2020:S0012-3692(20)31412-4. doi: 10.1016/j.chest.2020.04.061.

  8. Gabriel SE. The epidemiology of rheumatoid arthritis. Rheum Dis Clin North Am. 2001;27(2):269–281.

  9. Koo SM, Kim SY, Choi SM, et al. Korean guidelines for diagnosis and management of interstitial lung diseases: part 5. Connective tissue disease associated interstitial lung disease. Tuberc Respir Dis (Seoul). 2019;82(4):285–297.

  10. Demoruelle MK, Solomon JJ, Fischer A, Deane KD. The lung may play a role in the pathogenesis of rheumatoid arthritis. Int J Clin Rheumtol. 2014;9(3):295–309.

  11. Bilgici A, Ulusoy H, Kuru O, Celenk C, Unsal M, Danaci M. Pulmonary involvement in rheumatoid arthritis. Rheumatol Int. 2005;25(6):429–435.

  12. Chen J, Shi YH, Wang XP, Huang H, Ascherman D. Asymptomatic preclinical rheumatoid arthritis-associated interstitial lung disease. Clin Dev Immunol. 2013;2013:406927.

  13. Gochuico BR, Avila NA, Chow CK, et al. Progressive preclinical interstitial lung disease in rheumatoid arthritis. Arch Intern Med. 2008;168(2):159–166.

  14. Habib HM, Eisa AA, Arafat WR, et al. Pulmonary involvement in early rheumatoid arthritis patients. Clin Rheumatol. 2011;30:217–221.

  15. Mori S, Koga Y, Sugimoto M. Different risk factors between interstitial lung disease and airway disease in rheumatoid arthritis. Respir Med. 2012;106(11):1591–1599.

  16. Doyle TJ, Patel AS, Hatabu H, et al. Detection of rheumatoid arthritis–interstitial lung disease is enhanced by serum biomarkers. Am J Respir Crit Care Med. 2015;191(12):1403–1412.

  17. Giles JT, Danoff SK, Sokolove J, et al. Association of fine specificity and repertoire expansion of anticitrullinated peptide antibodies with rheumatoid arthritis associated interstitial lung disease. Ann Rheum Dis. 2014;73:1487–1494.

  18. Yin Y, Liang D, Zhao L, et al. Anti-cyclic citrullinated Peptide antibody is associated with interstitial lung disease in patients with rheumatoid arthritis. PLoS One. 2014;9(4):e92449.

  19. Bongartz T, Nannini C, Medina-Velasquez YF, et al. Incidence and mortality of interstitial lung disease in rheumatoid arthritis: a population-based study. Arthritis Rheum. 2010;62(6):1583–1591.

  20. Wallace B, Vummidi D, Khanna D. Management of connective tissue diseases associated interstitial lung disease: a review of the published literature. Curr Opin Rheumatol. 2016;28(3):236–245.

  21. Cassone G, Manfredi A, Vacchi C, et al. Treatment of rheumatoid arthritis-associated interstitial lung disease: lights and shadows. J Clin Med. 2020;9(4):1082.

  22. Iqbal K and Kelly C. Treatment of rheumatoid arthritis-associated interstitial lung disease: a perspective review. Ther Adv Musculoskelet Dis. 2015;7(6):247–267.

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