Photo Credit: DouglasOlivares

The following is a summary of “Interstitial Lung Disease in Patients With Rheumatoid Arthritis or Psoriatic Arthritis Initiating Biologics and Controls: Data From 5 Nordic Registries,” published in the September 2024 issue of Rheumatology by Provan et al. 

Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis (RA), but its prevalence in psoriatic arthritis (PsA) is unclear.  

Researchers conducted a retrospective study on patients with ILD in RA and PsA, investigating the debated role of methotrexate (MTX) in ILD development. 

They identified patients from 5 rheumatology registries, collecting data on demographics, MTX use, and disease activity. Matched general population subjects were sourced from 4 countries. The incidence of ILD during follow-up (up to 5 years) was assessed through national registries, excluding those with prior ILD. Adjusted hazard ratios (HRs) were calculated for ILD incidence between patients and the general population and for MTX users vs nonusers. 

The results showed that follow-up of 29,478 patients with RA and 10,919 patients with PsA initiating a first biologic disease-modifying antirheumatic drug (bDMARD), along with 362,087 population subjects, identified 225, 23, and 251 cases of ILD, respectively. The HRs for ILD compared to population subjects were 9.7 (95% CI 7.97-11.91) in RA and 4.4 (95% CI 2.83-6.97) in PsA. For patients with MTX comedication, HRs for ILD were 1.0 (95% CI 0.72-1.25) in RA and 0.9 (95% CI 0.38-2.05) in PsA. 

Investigators concluded that among patients with RA and PsA starting a bDMARD, the risk of ILD was higher than in the general population, particularly in RA. MTX comedication did not increase ILD risk. 

Source: jrheum.org/content/early/2024/09/24/jrheum.2024-0252