A LARGE-SCALE study from five Nordic rheumatology registries has revealed that patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) initiating biologic therapies face a significantly higher risk of developing interstitial lung disease (ILD) compared to the general population. However, the study also found no evidence that methotrexate (MTX), a common arthritis medication, increases the risk of ILD.
The study analysed data from 29,478 RA patients, 10,919 PsA patients, and 362,087 matched controls from the general population, excluding individuals with pre-existing ILD. During a follow-up period of up to five years, 225 cases of ILD were identified in RA patients, 23 in PsA patients, and 251 in controls.
RA patients were nearly 10 times more likely to develop ILD compared to the general population, while PsA patients had a risk over four times higher. Despite initial concerns, MTX use did not significantly influence ILD risk in either RA or PsA patients. Hazard ratios (HRs) for ILD with MTX comedication were 1.0 for RA and 0.9 for PsA, indicating no additional risk compared to non-users.
The findings highlight the need for careful monitoring of lung health in arthritis patients, particularly those with RA, who are at the highest risk of ILD. These insights can help clinicians better assess risks when initiating biologic therapies and reassure patients about the safety of MTX in relation to lung disease.
Reference
Provan SA et al. Interstitial Lung Disease in Patients With Rheumatoid Arthritis or Psoriatic Arthritis Initiating Biologics and Controls: Data From 5 Nordic Registries. J Rheumatol. 2024;51(11):1111-8.
