{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:04:38Z","timestamp":1790949878878,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T00:00:00Z","timestamp":1695340800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>Preclinical interstitial lung disease (pILD) may represent the early stages of rheumatoid arthritis-associated interstitial lung disease (RA-ILD). However, the characteristics, clinical outcomes, and risk factors associated with fibrosis progression in RA-ILD, including pILD and ILD, remain poorly understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Baseline data were compared between patients with RA-ILD and those with RA alone. Multivariate logistic regression and Cox regression analyses were performed to identify risk factors associated with the prevalence and imaging progression of RA-ILD, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 371 enrolled RA patients, 32.3% had RA-ILD. Multiple logistic regression analyses identified age over 60.0\u2009years (OR 2.22), smoking (OR 2.09), diabetes mellitus (DM) (OR 3.09), mixed connective tissue disease (MCTD) (OR 2.98), serum lactate dehydrogenase (LDH) levels exceeding 250.0\u2009U\/L (OR 6.73), and positive anti-cyclic citrullinated peptide (anti-CCP) antibody (OR 2.06) as independent risk factors for RA-ILD (<jats:italic>p<\/jats:italic>&amp;lt;\u20090.05 or 0.01). Among the 98 RA-ILD patients who underwent follow-up for a median duration of 19.1\u2009months, 51.0% demonstrated fibrotic progression on high-resolution computed tomography (HRCT). Multiple Cox regression analysis identified DM (HR 2.03), Disease Activity Score in 28 joints-Erythrocyte Sedimentation Rate (DAS28-ESR) greater than 5.1 (HR 2.21), and baseline HRCT scores exceeding 5.0 (HR 2.30) as independent risk factors for fibrosis progression in RA-ILD (<jats:italic>p<\/jats:italic>&amp;lt;\u20090.05 or 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nearly one-third of RA patients in this cohort had prevalent pILD or ILD, and half of them demonstrated imaging progression during follow-up. DM, higher DAS28-ESR, and advanced HRCT scores were identified as independent risk factors for progressive fibrosis in RA-ILD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1265355","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T09:28:17Z","timestamp":1695374897000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Progression of radiographic fibrosis in rheumatoid arthritis-associated interstitial lung disease"],"prefix":"10.3389","volume":"10","author":[{"given":"Dandan","family":"Chai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","article-title":"Rheumatoid arthritis","volume":"388","author":"Smolen","year":"2016","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"102735","DOI":"10.1016\/j.autrev.2020.102735","article-title":"Beyond the joints, the extra-articular manifestations in rheumatoid arthritis","volume":"20","author":"Conforti","year":"2021","journal-title":"Autoimmun Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"212","DOI":"10.4081\/reumatismo.2018.1106","article-title":"Extra-articular rheumatoid arthritis","volume":"70","author":"Marcucci","year":"2018","journal-title":"Reumatismo"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"210011","DOI":"10.1183\/16000617.0011-2021","article-title":"Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management","volume":"30","author":"Kadura","year":"2021","journal-title":"Eur Respir Rev"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"2000337","DOI":"10.1183\/13993003.00337-2020","article-title":"Methotrexate and rheumatoid arthritis associated interstitial lung disease","volume":"57","author":"Juge","year":"2021","journal-title":"Eur Respir J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1002\/art.40574","article-title":"The lung in rheumatoid arthritis: focus on interstitial lung disease","volume":"70","author":"Spagnolo","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.1002\/art.40904","article-title":"Rheumatoid arthritis disease activity predicting incident clinically apparent rheumatoid arthritis-associated interstitial lung disease: a prospective cohort study","volume":"71","author":"Sparks","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1183\/09059180.00008014","article-title":"Rheumatoid arthritis-associated lung disease","volume":"24","author":"Shaw","year":"2015","journal-title":"Eur Respir Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3689","DOI":"10.1093\/rheumatology\/keaa836","article-title":"Prevalence, incidence and cause-specific mortality of rheumatoid arthritis-associated interstitial lung disease among older rheumatoid arthritis patients","volume":"60","author":"Sparks","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"3234","DOI":"10.1093\/rheumatology\/keab891","article-title":"Screening for preclinical parenchymal lung disease in rheumatoid arthritis","volume":"61","author":"Esposito","year":"2022","journal-title":"Rheumatology (Oxford)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1700537","DOI":"10.1183\/13993003.00537-2017","article-title":"The MUC5B promoter polymorphism is associated with specific interstitial lung abnormality subtypes","volume":"50","author":"Putman","year":"2017","journal-title":"Eur Respir J"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1136\/thoraxjnl-2018-212446","article-title":"Interstitial lung abnormalities: erecting fences in the path towards advanced pulmonary fibrosis","volume":"74","author":"Hunninghake","year":"2019","journal-title":"Thorax"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1164\/rccm.201708-1679LE","article-title":"Histopathology of interstitial lung abnormalities in the context of lung nodule resections","volume":"197","author":"Miller","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/S2213-2600(20)30168-5","article-title":"Interstitial lung abnormalities detected incidentally on CT: a paper from the Fleischner society","volume":"8","author":"Hatabu","year":"2020","journal-title":"Lancet Respir Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1164\/rccm.202202-0399ST","article-title":"Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS\/ERS\/JRS\/ALAT clinical practice guideline","volume":"205","author":"Raghu","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e44","DOI":"10.1164\/rccm.201807-1255ST","article-title":"Diagnosis of idiopathic pulmonary fibrosis. An official ATS\/ERS\/JRS\/ALAT clinical practice guideline","volume":"198","author":"Raghu","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 rheumatoid arthritis classification criteria: an American College of Rheumatology\/European league against rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1164\/rccm.201809-1652OC","article-title":"Imaging patterns are associated with interstitial lung abnormality progression and mortality","volume":"200","author":"Putman","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1230","DOI":"10.1164\/rccm.201909-1834OC","article-title":"Development and progression of radiologic abnormalities in individuals at risk for familial interstitial lung disease","volume":"201","author":"Salisbury","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1546","DOI":"10.1016\/j.chest.2020.04.061","article-title":"Baseline characteristics and progression of a spectrum of interstitial lung abnormalities and disease in rheumatoid arthritis","volume":"158","author":"Kawano-Dourado","year":"2020","journal-title":"Chest"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1136\/annrheumdis-2017-211138","article-title":"A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: comorbidity and mortality","volume":"76","author":"Hyldgaard","year":"2017","journal-title":"Ann Rheum Dis"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1164\/rccm.201411-1950OC","article-title":"Detection of rheumatoid arthritis-interstitial lung disease is enhanced by serum biomarkers","volume":"191","author":"Doyle","year":"2015","journal-title":"Am J Respir Crit Care Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1016\/j.mayocp.2018.09.002","article-title":"Interstitial lung disease and other pulmonary manifestations in connective tissue diseases","volume":"94","author":"Mira-Avendano","year":"2019","journal-title":"Mayo Clin Proc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e30145","DOI":"10.7759\/cureus.30145","article-title":"Frequency of interstitial lung disease in rheumatoid arthritis patients: a hospital-based study","volume":"14","author":"Iqbal","year":"2022","journal-title":"Cureus"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"152004","DOI":"10.1016\/j.semarthrit.2022.152004","article-title":"Risk factors for the progression of rheumatoid arthritis-related interstitial lung disease: clinical features, biomarkers, and treatment options","volume":"55","author":"Chen","year":"2022","journal-title":"Semin Arthritis Rheum"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1111\/1756-185X.14351","article-title":"Predictors of progression in rheumatoid arthritis-associated interstitial lung disease: a single-center retrospective study from China","volume":"25","author":"Liu","year":"2022","journal-title":"Int J Rheum Dis"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"4667","DOI":"10.1093\/rheumatology\/keac208","article-title":"The impact of disease severity measures on survival in U.S. veterans with rheumatoid arthritis-associated interstitial lung disease","volume":"61","author":"Brooks","year":"2022","journal-title":"Rheumatology (Oxford)"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/resp.12234","article-title":"Predictors of mortality in rheumatoid arthritis-related interstitial lung disease","volume":"19","author":"Assayag","year":"2014","journal-title":"Respirology"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1183\/13993003.00357-2015","article-title":"Predictors of mortality in rheumatoid arthritis-associated interstitial lung disease","volume":"47","author":"Solomon","year":"2016","journal-title":"Eur Respir J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1002\/art.39971","article-title":"Progressive decline of lung function in rheumatoid arthritis-associated interstitial lung disease","volume":"69","author":"Zamora-Legoff","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1007\/s10067-017-3707-5","article-title":"Rheumatoid arthritis-related interstitial lung disease (RA-ILD): methotrexate and the severity of lung disease are associated to prognosis","volume":"36","author":"Rojas-Serrano","year":"2017","journal-title":"Clin Rheumatol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/151626","article-title":"Anti-cyclic citrullinated peptide antibodies and severity of interstitial lung disease in women with rheumatoid arthritis","volume":"2015","author":"Rocha-Mu\u00f1oz","year":"2015","journal-title":"J Immunol Res"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1265355\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T09:28:20Z","timestamp":1695374900000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1265355\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,22]]},"references-count":32,"alternative-id":["10.3389\/fmed.2023.1265355"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1265355","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,22]]},"article-number":"1265355"}}