A NEW study underscores the critical role of systemic inflammation in predicting interstitial lung disease (ILD) among patients with rheumatoid arthritis (RA), highlighting the need for close monitoring of inflammatory markers.
The study utilised data from the German biologics register RABBIT, spanning 2001 to 2021. Researchers conducted a nested case-control analysis, matching 139 RA patients who developed ILD to 686 controls without ILD.
The findings revealed that elevated levels of inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), significantly increased the risk of ILD. Patients with persistently high inflammation, indicated by log ESR (odds ratio [OR]: 1.86) and log CRP (OR: 1.55), were more likely to develop ILD compared to those with lower levels.
Interestingly, other components of RA disease activity, including joint counts and patient global assessments, were not significantly associated with ILD risk. These results remained consistent across multiple analyses, including cases with validated ILD diagnoses and those with observation times exceeding 12 months.
“Systemic inflammation, rather than joint-specific factors, appears to be a key driver of ILD development in RA patients,” the researchers noted.
The study calls for regular monitoring of CRP and ESR levels in RA management, regardless of joint symptom severity, to identify patients at higher risk of ILD, a potentially severe complication.
Aleksandra Zurowska, EMJ
Reference
Ramien R et al. Impact of systemic inflammation and disease activity on the incidence of interstitial lung disease in patients with rheumatoid arthritis – a nested case-control study within the German biologics register RABBIT. Arthritis Res Ther. 2024;DOI: 10.1186/s13075-024-03449-9.
