Background: Interstitial lung disease (ILD) is a common extra-articular manifestation of rheumatoid arthritis (RA). Previous studies have suggested pathophysiological links between ILD and the presence of anti-cyclic citrullinated peptide antibodies (anti-CCP antibodies). The main aim of our study was to evaluate the prevalence and features of RA-associated ILD (RA-ILD) and to explore a possible association between the presence of anti-CCP antibodies and the development of ILD.

Objectives: Examine the relationship between anti-CCP antibodies and diffuse interstitial pneumonia in rheumatoid arthritis, aiming to enhance strategies for early detection and effective management.

Methods: We conducted a prospective study that included 180 patients diagnosed with RA according to the ACR/EULAR 2010 criteria, from January 2022 to January 2023. Screening for RA-ILD and characterization of the ILD pattern were performed using high-resolution computed tomography, which was centrally interpreted by expert radiologists and pulmonologists.

Results: Of the 180 RA patients, 87.9% were female, with a median age of 56 years (interquartile range: 31 to 89 years). The median duration of RA was 8 years (interquartile range: 1 to 32 years). Erosive lesions were observed in 58% of patients on standard radiographs, anti-CCP antibodies were positive in 72% of cases, and rheumatoid factor (RF) was present in 62.9% of patients. The mean DAS28-CRP score was 4.48 ± 1.24. About 91% of patients had received at least one csDMARDs treatment, and nearly 59.8% were on biologic therapies. Moreover, 90.7% of patients had been treated with glucocorticoids. RA-ILD was present in 24.7% of patients, with a distribution of usual interstitial pneumonia (UIP) in 54% of cases, non-specific interstitial pneumonia (NSIP) in 43.18% of cases, and organized pneumonia (OP) in one patient. Factors associated with the presence of RA-ILD were male gender (p < 0.001) and a significant correlation with the presence of anti-CCP antibodies (p = 0.004).

Conclusion: Interstitial lung disease associated with rheumatoid arthritis requires special attention from rheumatologists due to its high prevalence, often asymptomatic nature, and tendency to progress to fibrosis. This study contributes to a better understanding of the relationship between RA and ILD, emphasizing the importance of early detection and management of this potentially severe complication.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.