Pulmonary disease is one of the most frequent and severe extraarticular manifestations of rheumatoid arthritis. Now, a study led by professionals from Bellvitge University Hospital and IDIBELL, published in the journal Arthritis Research & Therapy, with long-term monitoring of people with recent rheumatoid arthritis, reveals that 43.6% of people develop some type of respiratory affectation throughout the evolution of the disease.
The work analyses a cohort of 204 people with rheumatoid arthritis in initial phases, followed for up to eight years by a structured and repeated respiratory evaluation. This strategy has made it possible to detect subclinical pulmonary affectation -without obvious respiratory symptoms- in every one in four people.
An early and frequent affectation
The most common forms of pulmonary affectation were interstitial pulmonary disease and bronchiectasis, each present in approximately one in five people. The study also shows that the risk is especially high in people diagnosed with rheumatoid arthritis from the age of 60 and in men, especially in the case of interstitial pulmonary disease.
“Results confirm that lung affectation in rheumatoid arthritis is early, frequent, and often asymptomatic. For this reason, systematic respiratory screening from diagnosis is key to detecting it before serious complications appear”, explains Dr. Maria Molina, pneumologist and coordinator of the Functional Unit of Pulmonary Interstice of Bellvitge Hospital, scientific director of IDIBELL and head of the research group in Pneumology.
The study shows that almost half of the first episodes of pulmonary affectation appear in the first three years after the diagnosis of rheumatoid arthritis, questioning the traditional idea that it is a late complication.
Addressing reality with a multidisciplinary approach
“This work provides very solid incidence data and reinforces the need for a multidisciplinary approach between rheumatology, pneumology and radiology. Early detection of pulmonary affectation can have a direct impact on the prognosis and quality of life of people”, says Dr. Javier Narváez, head of the Rheumatology Service at Bellvitge Hospital and researcher in the Sinovial Inflammation and Bone Metabolism group at IDIBELL.
The research team emphasizes that the structured monitoring strategy applied to Bellvitge has allowed to obtain one of the highest incidence estimates described so far, precisely because it identifies cases that would usually go unnoticed if only people with respiratory symptoms were evaluated.
The conclusions of the study support the recent recommendations of several scientific societies that propose systematic respiratory assessments in people with rheumatoid arthritis, with the aim of improving early detection and long-term clinical results.
The Bellvitge Biomedical Research Institute (IDIBELL) is a research center established in 2004 specialized in cancer, neuroscience, translational medicine, and regenerative medicine. It counts on a team of more than 1.500 professionals who, from 73 research groups, publish more than 1.400 scientific articles per year. IDIBELL is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona, and the City Council of L’Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).