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Chest. 2014 Mar 1;145(3):454-463. doi: 10.1378/chest.13-2408.

A roadmap to promote clinical and translational research in rheumatoid arthritis-associated interstitial lung disease.

Author information

1
Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
2
Division of Pulmonary and Critical Care Medicine, University of California San Francisco School of Medicine, San Francisco, CA.
3
Division of Rheumatology, Immunology, and Allergy Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
4
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
5
Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN.
6
Division of Rheumatology, National Jewish Health and University of Colorado, Denver, CO.
7
Division of Rheumatology, University of Miami Miller School of Medicine, Miami, FL.
8
Division of Pulmonary Medicine, University of Miami Miller School of Medicine, Miami, FL.
9
Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN.
10
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
11
Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO.
12
Lovelace Respiratory Research Institute, Albuquerque, NM. Electronic address: irosas@rics.bwh.harvard.edu.

Abstract

Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting approximately 1.3 million adults in the United States. Approximately 10% of these individuals with RA have clinically evident interstitial lung disease (RA-ILD), and an additional one-third demonstrate subclinical ILD on chest CT scan. The risk of death for individuals with RA-ILD is three times higher than for patients with RA without ILD, with a median survival after ILD diagnosis of only 2.6 years. Despite the high prevalence and mortality of RA-ILD, little is known about its molecular features and its natural history. At present, we lack a standard validated approach to the definition, diagnosis, risk stratification, and management of RA-ILD. In this perspective, we discuss the importance of clinical and translational research and how ongoing research efforts can address important gaps in our knowledge over the next few years. Furthermore, recommendations are made to design multicenter collaborative studies that will expedite the development of clinical trials designed to decrease the significant morbidity and mortality associated with RA-ILD.

PMID:
24590021
PMCID:
PMC3941243
DOI:
10.1378/chest.13-2408
[Indexed for MEDLINE]
Free PMC Article
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