Rheumatoid arthritis (RA) related interstitial lung disease (ILD) impacts on the treatment strategy and its prognosis in patients with RA. However, the relationship between RA disease activity and the severity of comorbid ILD has not been fully investigated. This study aimed to investigate the impact of RA disease activity on the severity of comorbid ILD in detail based on currently established visual scoring method along with physiological severity. Consecutive patients with RA visiting to our Rheumatology Centre between December 2020 and December 2023 were analysed. The radiological severity of ILD was evaluated by averaging the extent of the combined lesion of ground glass opacity, reticulation and honeycombing in 5% increments in six representative high-resolution computed tomography slices ranging from 0% (no involvement) to 100% (all lung fields affected) according to Goh and Walsh’s method. Associations between the radiological and physiological severity of ILD and patients’ features were investigated using linear regression analysis. Among 124 patients (32 men, 92 women), the median age was 70 years, and the median disease duration was 2.92 years. Radiological severity of ILD was 0% (without ILD) in 107 (86.2%), ILD with extent < 10% in nine (7.2%), ILD with extent ≥10% and < 20% in three (2.4%), ILD with extent ≥20% in five (4.0%). Both disease activity score (DAS)28-erythrocyte sedimentation rate (ESR) (standardized coefficient = 0.199, P = 0.03) and rheumatoid factor titre (standardized coefficient = 0.247, P = 0.01) were significantly associated with the radiological quantitative severity of ILD in multivariate analysis adjusted for age, sex, disease duration, smoking status and anti-citrullinated peptide antibody titre. DAS28-ESR was significantly associated with forced vital capacity% predicted (standardized coefficient = -0.230, P = 0.047). Disease activity of RA was significantly associated with the severity of RA-ILD both radiologically and physiologically.

中文翻译：

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类风湿性关节炎疾病活动显着影响间质性肺疾病的严重程度

类风湿性关节炎（RA）相关间质性肺疾病（ILD）对 RA 患者的治疗策略及其预后有影响。然而，RA 疾病活动性与共病 ILD 严重程度之间的关系尚未得到充分研究。本研究旨在基于目前建立的视觉评分方法以及生理严重程度，详细研究 RA 疾病活动度对共病 ILD 严重程度的影响。我们对 2020 年 12 月至 2023 年 12 月期间连续到我们风湿病中心就诊的 RA 患者进行了分析。 ILD 的放射学严重程度的评估方法是，在 6 个代表性高分辨率计算机断层扫描切片中，以 5% 的增量对毛玻璃样混浊、网状和蜂窝状的综合病变程度进行平均，范围从 0%（无受累）到 100%（所有肺）。根据 Goh 和 Walsh 的方法。使用线性回归分析研究 ILD 的放射学和生理学严重程度与患者特征之间的关联。 124 名患者（32 名男性，92 名女性）中，中位年龄为 70 岁，中位病程为 2.92 年。 107 名 (86.2%) 的 ILD 放射学严重程度为 0%（无 ILD），9 名 (7.2%) 的 ILD 范围 < 10%，3 名 (2.4%) 的 ILD 范围≥10% 且 < 20%，有 ILD五种程度≥20% (4.0%)。疾病活动评分 (DAS)28-红细胞沉降率 (ESR)（标准化系数 = 0.199，P = 0.03）和类风湿因子滴度（标准化系数 = 0.247，P = 0.01）均与 ILD 的放射学定量严重程度显着相关。多变量分析调整了年龄、性别、病程、吸烟状况和抗瓜氨酸肽抗体滴度。 DAS28-ESR 与预测的用力肺活量百分比显着相关（标准化系数 = -0.230，P = 0.047）。 RA 的疾病活动度与 RA-ILD 的放射学和生理学严重程度显着相关。