From the Journals

Call it preclinical or subclinical, ILD in RA needs to be tracked


 

Screening and future research

While there is no evidence to recommend screening patients for ILD using CT, there are certain risk factors for ILD in RA patients, including a history of smoking, male sex, and high RA disease activity despite antirheumatic treatment, Dr. Volkmann said. In both of their practices, Dr. Davis and Dr. Volkmann screen with RA via HRCT and PFTs for ILD for patients with known risk factors that predispose them to the lung condition and/or for patients who report respiratory symptoms.

Dr. Joshua J. Solomon, a pulmonologist at National Jewish Health, Denver National Jewish Health

Dr. Joshua J. Solomon

“We still don’t have an algorithm [for screening patients], and that is a desperate need in this field,” added Joshua J. Solomon, MD, a pulmonologist at National Jewish Health, Denver, whose research focuses on RA-associated ILD. While recommendations state that all patients with scleroderma should be screened with CT, ILD incidence is lower among patients with RA, and thus these screening recommendations need to be narrowed, he said. But more research is needed to better fine tune recommendations, he said; “The only thing you can do is give some expert consensus until there are good data.”

Dr. Volkmann has received consulting and speaking fees from Boehringer Ingelheim and institutional support for performing studies on systemic sclerosis for Kadmon, Forbius, Boehringer Ingelheim, Horizon, and Prometheus. Dr. Gordon, Dr. Davis, and Dr. Solomon report no relevant financial relationships.

A version of this article first appeared on Medscape.com.

Pages

Recommended Reading

Family history and smoking linked to higher RA risk
MDedge Rheumatology
Higher incidence of herpes zoster in patients with RA
MDedge Rheumatology
Specific ACPA and anti-native protein antibodies predict risk for RA-associated ILD
MDedge Rheumatology
Are repeat radiographs necessary in rheumatoid and psoriatic arthritis?
MDedge Rheumatology
New influx of Humira biosimilars may not drive immediate change
MDedge Rheumatology
Expert offers caveats to perioperative antirheumatic drug guideline
MDedge Rheumatology
What’s holding back physicians from prescribing biosimilars? Four specialties weigh in
MDedge Rheumatology
Bacteremia, antibodies link periodontal disease to RA development and activity
MDedge Rheumatology
FDA approves first biologic treatment for polymyalgia rheumatica
MDedge Rheumatology
Commentary: ILD and other issues in RA treatment, March 2023
MDedge Rheumatology