CHEST Guidelines-Airways-Abnormalities-in-a-Prospective-Cohort-of-P

Airways-Abnormalities-in-a-Prospective-Cohort-of-P

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The study "Airways Abnormalities in a Prospective Cohort of Patients With Rheumatoid Arthritis" investigates the prevalence and implications of airways abnormalities in patients with rheumatoid arthritis (RA), a condition that affects about 1% of the population and often involves lung complications. While interstitial lung disease in RA is well-documented, airways disease has not been studied extensively in this context. <br /><br />The research included 188 RA patients without clinical interstitial lung disease (ILD), who underwent pulmonary function tests (PFTs) and high-resolution CT (HRCT) scans analyzed both by radiologists and quantitative imaging software. Results showed 20.7% had airways obstruction as indicated by an FEV1 to FVC ratio of ≤0.7. Radiologists identified abnormalities in 61% of patients, notably bronchial wall thickening, bronchiectasis, and mosaic attenuation. These abnormalities correlated with older age, male sex, smoking history, and rheumatoid factor positivity. Importantly, quantitative measures of airway abnormalities, such as wall thickening percentage and emphysema percentage, were significantly associated with more severe respiratory symptoms like shortness of breath and cough.<br /><br />The study reveals a high prevalence of airway abnormalities in RA patients, suggesting RA airways disease may be an underrecognized condition impacting patient health. Quantitative CT imaging could serve as a more sensitive diagnostic tool for these lung issues compared to traditional methods. This research emphasizes considering RA-AWD as a distinct clinical entity and exploring whether disease-modifying antirheumatic drugs could positively impact these lung manifestations, instead of solely relying on typical pulmonologist-directed treatments like inhaled bronchodilators or corticosteroids. Further longitudinal studies are recommended to better understand and manage this aspect of RA.

Keywords

rheumatoid arthritis

airways abnormalities

lung complications

pulmonary function tests

high-resolution CT

bronchial wall thickening

quantitative imaging

respiratory symptoms

RA airways disease

disease-modifying antirheumatic drugs