Incidence and spectrum of primary respiratory disease throughout the course of rheumatoid arthritis: implications of structured repeated evaluation for detection and risk-factor analysis
Authors' conclusion
Proactive screening identified a high incidence of ILD and airway disease in early RA
Study context
- Population
- Early RA patients screened for lung involvement at RA onset and during follow-up
- Participants
- 204 patients
- Outcome
- Incidence and spectrum of lung involvement
- Follow-up
- 4 and 8 years
Methodological detailsstructured repeated respiratory screening, Cox regression
- Structured repeated respiratory screening
- Cox regression
Main finding
As reported in the abstract
Pulmonary involvement
- Pulmonary involvement, n/N (%)
- 89 of 204 (43.6%)
- Cumulative incidence at 4 years
- 17.5%
- Cumulative incidence at 8 years
- 25.2%
- Incidence rate (IR) per 1,000 person-years, without prior lung disease
- 42.0
- IR per 1,000 person-years, including pre-existing cases
- 50.2
- Asymptomatic lung involvement detected by screening
- 51/204
Observational data: associations, not effects.
Further findings
Risk factors: age at RA onset ≥ 60 years
| HR (95% CI) | ||
|---|---|---|
| Age at RA onset ≥ 60 yearsOverall lung involvement; independent association | 2.22 (1.20–4.11) | |
| Age at RA onset ≥ 60 yearsILD | 3.36 (1.23–9.20) | |
| Age at RA onset ≥ 60 yearsBronchiectasis | 2.42 (1.07–5.43) | |
| 0.10.31310Hazard ratio (log scale) |
Risk factors: male sex and interstitial lung disease (ILD)
| HR (95% CI) | ||
|---|---|---|
| Male sexILD | 5.11 (1.52–17.13) | |
| 0.050.21520Hazard ratio (log scale) |
Frequency of manifestations
- ILD
- 22.5%
- Bronchiectasis
- 22.1%
- Follicular bronchiolitis
- 7.8%
- Pulmonary nodules
- 5.4%
- Pleural disease
- 3.4%
- Obliterative bronchiolitis
- 1%
IR by manifestation
- Bronchiectasis
- 20.4
- ILD
- 16.2
- Follicular bronchiolitis
- 6.9
- Nodules
- 4.9
- Pleural disease
- 2.0
- Obliterative bronchiolitis
- 1.0
Cumulative incidence by manifestation · 4 and 8 years
- Bronchiectasis, 4 years
- 8.8%
- Bronchiectasis, 8 years
- 12.9%
- ILD, 4 years
- 7.5%
- ILD, 8 years
- 11.6%
Original publication
Incidence and spectrum of primary respiratory disease throughout the course of rheumatoid arthritis: implications of structured repeated evaluation for detection and risk-factor analysis. Arthritis Res Ther. Published 23 January 2026. doi:10.
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