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Respiration. 2018;95(4):244-250. doi: 10.1159/000485631. Epub 2018 Feb 28.

Association between Rheumatoid Arthritis and Pulmonary Hypertension: Data from the French Pulmonary Hypertension Registry.

Montani D1,2,3, Henry J4, O'Connell C1,2,3, Jaïs X1,2,3, Cottin V5, Launay D6,7,8,9, Habib G10, Bourdin A11, Jevnikar M1,2,3, Savale L1,2,3, Rottat L1,2,3, Simonneau G1,2,3, Sitbon O1,2,3, Humbert M1,2,3, Allanore Y4.

Author information

1
Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
2
AP-HP, Service de Pneumologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
3
Inserm UMR_S 999, Hôpital Marie-Lannelongue, Le Plessis-Robinson, France.
4
Department of Rheumatology A, Hôpital Cochin, AP-HP, Université Paris 5 René Descartes, Paris, France.
5
Université Claude-Bernard Lyon 1, Hôpital Louis-Pradel, Service de Pneumologie, Centre de Référence National des Maladies Pulmonaires Rares, Lyon, France.
6
Université Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France.
7
Département de Médecine Interne et Immunologie Clinique, CHU Lille, Lille, France.
8
Centre National de Référence Maladies Systémiques et Auto-immunes Rares (Sclérodermie Systémique), Lille, France.
9
FHU Immune-Mediated Inflammatory Diseases and Targeted Therapies, Lille, France.
10
Service de Cardiologie, Hôpital de la Timone, Marseille, France.
11
Department of Respiratory Diseases, INSERM U1046, Hôpital Arnaud-de-Villeneuve, Université Montpellier I et II, Montpellier, France.

Abstract

BACKGROUND:

Precapillary pulmonary hypertension (PH), and particularly pulmonary arterial hypertension (PAH), is a life-threatening complication of connective tissue diseases (systemic sclerosis, systemic lupus erythematosus, and mixed connective tissue disease). The relationship between PH and rheumatoid arthritis (RA) has not been clearly established.

OBJECTIVES:

The aim of the study was to evaluate the relationship between precapillary PH and RA.

METHODS:

We identified patients with PH and suspected RA included in the French PH Registry between 1 May 2004 and 31 December 2012 and evaluated the prevalence of confirmed RA in this population. RA phenotypes, clinical, functional, and hemodynamic data, and patient outcomes were recorded.

RESULTS:

RA was confirmed in 20 patients (70% female; mean age 52 years) with precapillary PH, including 10 patients with PAH, 6 with severe PH due to lung disease, and 4 with chronic thromboembolic PH. The prevalence of RA was 0.35% (95% CI: 0.23-0.54) in the French PH Registry and 0.58% (95% CI: 0.30-1.11) in idiopathic PAH, comparable to that in the general population. The RA phenotype was characterized by the presence of specific RA autoantibodies and joint erosions in 75% of the patients. The outcomes of PH in the RA patients were unremarkable compared to those in other patients from the registry, and RA therapies had no major impact on the cardiopulmonary parameters.

CONCLUSION:

When precapillary PH occurs in RA patients, all PH subsets may be identified. The RA prevalence in the French PH Registry is similar to that in the general population, which does not support a specific association or an indication for PH screening in RA patients.

KEYWORDS:

Connective tissue disease; Pulmonary hypertension; Rheumatoid arthritis

PMID:
29490304
DOI:
10.1159/000485631
[Indexed for MEDLINE]
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