Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian Study
Background: The INBUILD study demonstrated the efficacy of nintedanib in the treatment of progressive fibrosing interstitial lung disease different to idiopathic pulmonary fibrosis, including rheumatoid arthritis (RA)-related ILD. Nevertheless, the prevalence of RA-ILD patients that may potentially...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-11-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/22/7041 |
| _version_ | 1797458865355227136 |
|---|---|
| author | Marco Sebastiani Vincenzo Venerito Elenia Laurino Stefano Gentileschi Fabiola Atzeni Claudia Canofari Dario Andrisani Giulia Cassone Marlea Lavista Francesco D’Alessandro Caterina Vacchi Arnaldo Scardapane Bruno Frediani Massimiliano Cazzato Carlo Salvarani Florenzo Iannone Andreina Manfredi |
| author_facet | Marco Sebastiani Vincenzo Venerito Elenia Laurino Stefano Gentileschi Fabiola Atzeni Claudia Canofari Dario Andrisani Giulia Cassone Marlea Lavista Francesco D’Alessandro Caterina Vacchi Arnaldo Scardapane Bruno Frediani Massimiliano Cazzato Carlo Salvarani Florenzo Iannone Andreina Manfredi |
| author_sort | Marco Sebastiani |
| collection | DOAJ |
| description | Background: The INBUILD study demonstrated the efficacy of nintedanib in the treatment of progressive fibrosing interstitial lung disease different to idiopathic pulmonary fibrosis, including rheumatoid arthritis (RA)-related ILD. Nevertheless, the prevalence of RA-ILD patients that may potentially benefit from nintedanib remains unknown. Objectives and methods: The aim of the present multicentre study was to investigate the prevalence and possible associated factors of fibrosing progressive patterns in a cross-sectional cohort of RA-ILD patients. Results: One hundred and thirty-four RA-ILD patients with a diagnosis of RA-ILD, who were confirmed at high-resolution computed tomography and with a follow-up of at least 24 months, were enrolled. The patients were defined as having a progressive fibrosing ILD in case of a relative decline in forced vital capacity > 10% predicted and/or an increased extent of fibrotic changes on chest imaging in a 24-month period. Respiratory symptoms were excluded to reduce possible bias due to the retrospective interpretation of cough and dyspnea. According to radiologic features, ILD was classified as usual interstitial pneumonia (UIP) in 50.7% of patients, nonspecific interstitial pneumonia in 19.4%, and other patterns in 29.8%. Globally, a fibrosing progressive pattern was recorded in 36.6% of patients (48.5% of patients with a fibrosing pattern) with a significant association to the UIP pattern. Conclusion: We observed that more than a third of RA-ILD patients showed a fibrosing progressive pattern and might benefit from antifibrotic treatment. This study shows some limitations, such as the retrospective design. The exclusion of respiratory symptoms’ evaluation might underestimate the prevalence of progressive lung disease but increases the value of results. |
| first_indexed | 2024-03-09T16:43:17Z |
| format | Article |
| id | doaj.art-b58d2a8c24e64a64b8bbfb7c8738f219 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:43:17Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-b58d2a8c24e64a64b8bbfb7c8738f2192023-11-24T14:49:15ZengMDPI AGJournal of Clinical Medicine2077-03832023-11-011222704110.3390/jcm12227041Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian StudyMarco Sebastiani0Vincenzo Venerito1Elenia Laurino2Stefano Gentileschi3Fabiola Atzeni4Claudia Canofari5Dario Andrisani6Giulia Cassone7Marlea Lavista8Francesco D’Alessandro9Caterina Vacchi10Arnaldo Scardapane11Bruno Frediani12Massimiliano Cazzato13Carlo Salvarani14Florenzo Iannone15Andreina Manfredi16Rheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41121 Modena, ItalyRheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari “Aldo Moro”, 70121 Bari, ItalyRheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyRheumatology Unit, Azienda Ospedaliero-Universitaria Senese, Università Degli Studi di Siena, 53100 Siena, ItalyRheumatology Unit, University of Messina, 98122 Messina, ItalyRheumatology Unit, Azienda Ospedaliera San Camillo Forlanini, 00152 Roma, ItalyRespiratory Disease Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41121 Modena, ItalyRheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41121 Modena, ItalyRheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari “Aldo Moro”, 70121 Bari, ItalyRheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyRheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41121 Modena, ItalyRadiology Unit, University of Bari “Aldo Moro”, 70121 Bari, ItalyRheumatology Unit, Azienda Ospedaliero-Universitaria Senese, Università Degli Studi di Siena, 53100 Siena, ItalyRheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, ItalyRheumatology Unit, AUSL Reggio Emilia-IRCCS, University of Reggio Emilia, 42123 Reggio Emilia, ItalyRheumatology Unit, Department of Precision and Regenerative Medicine-Ionian Area, University of Bari “Aldo Moro”, 70121 Bari, ItalyRheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41121 Modena, ItalyBackground: The INBUILD study demonstrated the efficacy of nintedanib in the treatment of progressive fibrosing interstitial lung disease different to idiopathic pulmonary fibrosis, including rheumatoid arthritis (RA)-related ILD. Nevertheless, the prevalence of RA-ILD patients that may potentially benefit from nintedanib remains unknown. Objectives and methods: The aim of the present multicentre study was to investigate the prevalence and possible associated factors of fibrosing progressive patterns in a cross-sectional cohort of RA-ILD patients. Results: One hundred and thirty-four RA-ILD patients with a diagnosis of RA-ILD, who were confirmed at high-resolution computed tomography and with a follow-up of at least 24 months, were enrolled. The patients were defined as having a progressive fibrosing ILD in case of a relative decline in forced vital capacity > 10% predicted and/or an increased extent of fibrotic changes on chest imaging in a 24-month period. Respiratory symptoms were excluded to reduce possible bias due to the retrospective interpretation of cough and dyspnea. According to radiologic features, ILD was classified as usual interstitial pneumonia (UIP) in 50.7% of patients, nonspecific interstitial pneumonia in 19.4%, and other patterns in 29.8%. Globally, a fibrosing progressive pattern was recorded in 36.6% of patients (48.5% of patients with a fibrosing pattern) with a significant association to the UIP pattern. Conclusion: We observed that more than a third of RA-ILD patients showed a fibrosing progressive pattern and might benefit from antifibrotic treatment. This study shows some limitations, such as the retrospective design. The exclusion of respiratory symptoms’ evaluation might underestimate the prevalence of progressive lung disease but increases the value of results.https://www.mdpi.com/2077-0383/12/22/7041rheumatoid arthritisinterstitial lung disease (ILD)progressive fibrosing ILDhigh-resolution computed tomographynintedanib |
| spellingShingle | Marco Sebastiani Vincenzo Venerito Elenia Laurino Stefano Gentileschi Fabiola Atzeni Claudia Canofari Dario Andrisani Giulia Cassone Marlea Lavista Francesco D’Alessandro Caterina Vacchi Arnaldo Scardapane Bruno Frediani Massimiliano Cazzato Carlo Salvarani Florenzo Iannone Andreina Manfredi Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian Study Journal of Clinical Medicine rheumatoid arthritis interstitial lung disease (ILD) progressive fibrosing ILD high-resolution computed tomography nintedanib |
| title | Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian Study |
| title_full | Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian Study |
| title_fullStr | Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian Study |
| title_full_unstemmed | Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian Study |
| title_short | Fibrosing Progressive Interstitial Lung Disease in Rheumatoid Arthritis: A Multicentre Italian Study |
| title_sort | fibrosing progressive interstitial lung disease in rheumatoid arthritis a multicentre italian study |
| topic | rheumatoid arthritis interstitial lung disease (ILD) progressive fibrosing ILD high-resolution computed tomography nintedanib |
| url | https://www.mdpi.com/2077-0383/12/22/7041 |
| work_keys_str_mv | AT marcosebastiani fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT vincenzovenerito fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT elenialaurino fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT stefanogentileschi fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT fabiolaatzeni fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT claudiacanofari fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT darioandrisani fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT giuliacassone fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT marlealavista fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT francescodalessandro fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT caterinavacchi fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT arnaldoscardapane fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT brunofrediani fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT massimilianocazzato fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT carlosalvarani fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT florenzoiannone fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy AT andreinamanfredi fibrosingprogressiveinterstitiallungdiseaseinrheumatoidarthritisamulticentreitalianstudy |