Marie Doyen1, Marie Perrot2, Benoit Ghaye3, Emilie Sapart1, Deniz Zan3, Aleksandra avramovska1, Tatiana Sokolova4, maria stoenoiu1, sandra koenig2, antoine froidure2 and Patrick Durez5, 1Rheumatology department, Cliniques Universitaires Saint-Luc, Brussels, Belgium, 2Pulmonology department, Cliniques Universitaires Saint-Luc, Brussels, Belgium, 3Radiology department, Cliniques Universitaires Saint-Luc, Brussels, Belgium, 4Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium, 5Institute de Recherche Expérimentale et Clinique (IREC), Cliniques Universitaires Saint-Luc - Université Catholique de Louvain (UCL), Brussels, Belgium
Background/Purpose: The prevalence of lung involvement in rheumatoid arthritis (RA) remains elusive. We set up a prospective study to detect ILD, bronchiolitis and nodules in early RA.
Methods: The Factors of ILD in Newly Diagnosed RA (FINDRA, NCT04002765) study is a prospective trial. We proposed inclusion to patients with a newly diagnosed RA according to ACR/EULAR criteria. We defined early disease as symptoms present for at least 1 year and maximum 10 years. After informed consent, patients underwent full respiratory evaluation consisting of an environmental questionnaire, HRCT with expiratory acquisition and pulmonary function tests (PFT). HRCT were centrally reviewed for the presence of ILD (primary outcome), expiratory trapping and nodules (secondary outcomes).
Results: As of October 31st 2021, 245 patients had been included. We excluded 32 patients from the present analysis due to pending exams (HRCT and/or PFT). 148 (59%) of the 213 patients were females. 99 (53%) were ex or current smokers, with a median of 20 pack-years. The average age of the population is 54.8 years, DS±14.0; with mean disease duration of 6.3 years, DS±3.4; the mean DAS28-CRP is 2.17, DS±0.89 and the mean HAQ is 0.58, DS±0.63. 70.5% of the patients are positive for ACPA antibodies. 34 (16%) were exposed to a toxic. ILD was detected in 25 patients (12%). RA-ILD patients were significantly older (68 vs 54.5, P< 0.0001) and 48% were male. The RA disease activity score (DAS28-CRP) was statistically higher in RA-ILD patients (2.55 vs 2.12, P=0.028). Median DLCO was lower in RA-ILD (71% vs 84%, P=0.0003). Air trapping consistent with bronchiolitis was present in 123 patients (58%). Patients with trapping were older (57 vs 49, P< 0.0001). Neither sex nor smoking was related to the presence of air trapping. Finally, 23 patients (11%) had at least one nodule detected on HRCT.
Conclusion: In this interim analysis, we detected RA-ILD and signs of bronchiolitis in 12 and 58% of patients, respectively. Age was a risk factor for both, ILD was associated with male gender and higher DAS score.
Disclosures: M. Doyen, None; M. Perrot, None; B. Ghaye, None; E. Sapart, None; D. Zan, None; A. avramovska, None; T. Sokolova, None; m. stoenoiu, None; s. koenig, None; a. froidure, None; P. Durez, AbbVie, Galapagos, Lilly.
