scholarly journals Correlation of Rheumatoid Factor Serotypes and Computed Tomography Findings in Rheumatoid Arthritis Related Interstitial Lung Disease

2019 ◽  
Vol 14 (2) ◽  
pp. 203-211
Author(s):  
Rajalingham Sakthiswary ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Rheumatoid Factor

scholarly journals AB0235 RITUXIMAB (BIOSIMILAR) IN RHEUMATOID ARTHRITIS: CLINICAL & IMMUNOLOGICAL RESPONSE TO VARYING DOSES- EXPERIENCES FROM A TERTIARY CARE CENTER IN SOUTH INDIA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1143.2-1144
Author(s):  
J. Antony ◽  
R. Sankaralingam ◽  
R. Maheshwari ◽  
B. Chilukuri ◽  
S. Chinnadurai
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
Interstitial Lung Disease ◽  
Complete Remission ◽  
Lung Disease ◽  
Clinical Remission ◽  
Clinical Indication ◽  
Fixed Dose ◽  
Double Negative ◽  
Lung Involvement

Background:Rituximab (RTX) is a chimeric monoclonal antibody against CD20. There is a paucity of studies done with RTX biosimilars. This is a Retrospective and Observational study from January 2018 to December 2019 done in the Department of Clinical Immunology & Rheumatology, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.Objectives:1.To find the effects of varying doses of RTX in attaining clinical remission in RA.2.To find if CD19, CD20 & IgG help in identifying impending flare & if these levels help in deciding the timing of the next dose of RTX.Methods:Rheumatoid arthritis (RA) cases who were given Rituximab from January 2018 were selected. Clinical Response at 6 & 12 months & wherever feasible at 18 & 24 months was assessed by Simplified Disease Activity index (SDAI). RTX initial dose was given at 0 and 14 days followed by fixed dose at six months interval.CD19, CD20 B cell count, IgG levels were tested in patients in whom it was feasible at baseline & 6 months (select patients at 12,18 &24 months). Patients were divided in to 5 groups (DMARD naïve, DMARD resistant & Interstitial Lung disease (ILD) [Lung involvement>20% in Computed Tomography (CT)]) and (500mg & 1g). Patients were divided into three clinical groups, (DMARD naïve, DMARD resistant & Interstitial Lung disease (ILD) [Lung involvement>20% in Computed Tomography (CT)]) and two treatment groups (500mg & 1g) based on clinical indication for RTX and dose of RTX, respectively. In patients with ILD, CT scan & FVC were compared at baseline & 12 months.Results:29 patients (seropositive 28 (RF/Anti CCP/BOTH+VE), seronegative 1) were given RTX for RA over a 2-year period of which 12 had CD19, CD20 & IgG tested. Mean SDAI reduction from baseline to 6 months post treatment was 30%, 32% & 14% while complete remission (SDAI<3.3) was attained in 100%, 18% & 20% in DMARD naïve, DMARD resistant & ILD groups, respectively. CD19, CD20 & IgG reduced from 18.6%, 18.4% & 18.53g/L to 3.7%,3.7% & 9.7g/L respectively FVC improved from 62.4% to 67% at 12. The percentage of patients with lung involvement >20% reduced from 53.3% to 46.7%. Flare was observed in one patient who received 500mg RTX. CD19, CD20 & IgG levels increased from 7.9%, 8% & 9.8g/L to 27%, 25% & 13g/L respectively. 3 patients in the 1g group were followed up at 12,18 & 24 months. In these patients there were no flares or worsening symptoms. 1 patient was double negative for RF & Anti CCP and this patient did not attain clinical remission even after 2 doses of 1g RTX.Conclusion:[1]Patients with early arthritis (diagnosis made within 1 year) and who were DMARD naïve had an excellent response to Rituximab.[2]Complete remission was observed in more patients the 1g compared to 500mg group.[3]Reduction in CD19 & CD20 was associated with significant reduction in the SDAI score.[4]There was no significant reduction of CD19 & CD20 with 500mg dose of Rituximab where either a partial remission or mild flare was observed.[5]There was reduction in the lung involvement to less than 20%(CT) in few patients with 1g dose.[6]Double negative Rheumatoid arthritis poorly responded to Rituximab.[7]The positive effects of 1g Rituximab could be noted up to 24 months.[8]Flare of RA was associated with significant increase in CD19 & CD20.Disclosure of Interests:None declared

AB0175 Prevalence and Significance of Rheumatoid Factor and Anti-CCP in Patients with Interstitial Lung Disease and Rheumatoid Arthritis

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 956.2-956
Author(s):  
C. Aguilera Cros ◽  
A. Ruíz Román ◽  
M. Lisbona Muñoz ◽  
M. Luque Leόn ◽  
P. Leόn Rubio ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Rheumatoid Factor

scholarly journals Rheumatoid Arthritis Related Interstitial Lung Disease: Patterns of High-resolution Computed Tomography

Cureus ◽  
2020 ◽  
Author(s):  
Mahesh Gautam ◽  
Mah Jabeen Masood ◽  
Sadaf Arooj ◽  
Mufazzal-e-Haque Mahmud ◽  
Muhammad Umer Mukhtar
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
High Resolution Computed Tomography ◽  
Disease Patterns

scholarly journals FRI0049 RHEUMATOID ARTHRITIS ASSOCIATED INTERSTITIAL LUNG DISEASE: TOBACCO AND OTHER RISK FACTORS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 600.2-600
Author(s):  
C. Aguilera Cros ◽  
M. Gomez Vargas ◽  
R. J. Gil Velez ◽  
J. A. Rodriguez Portal
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Computed Tomography ◽  
High Resolution ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Poor Prognosis ◽  
American Thoracic Society ◽  
High Resolution Computed Tomography ◽  
Male Sex

Background:Among the risk factors associated with the development of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA) are: male sex, old age, erosive RA, rheumatoid nodules, smoking and high levels of rheumatoid factor (RF) and anticitrullinated protein antibody (ACPA). The factors of poor prognosis include: HRCT (High Resolution Computed Tomography) pattern of usual interstitial pneumonia (NIU) with altered baseline functional tests (forced vital capacity FVC <60%, diffusion capacity of the lung for carbon monoxide DLCO<40%).RA associated UIP (RA-UIP) has an appearance that is identical to idiopathic UIP (idiopathic pulmonary fibrosis [IPF]) on HRCT.Objectives:To analyze different risk factors and poor prognosis in a cohort of patients with ILD-RA.To assess the degree of association between tobacco (smokers, ex-smokers and non-smokers) and altered baseline functional respiratory tests (FRT) (FVC <80% and DLCO <40%) with HRCT patterns.Methods:Descriptive study of 57 patients treated in our Hospital (1/1/2018 until 12/31/2019) with a diagnosis of RA (ACR 2010 criteria) and secondary ILD.The most recent American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society (JRS)/Latin American Thoracic Society (ALAT) guidelines define three HRCT (High Resolution Computed Tomography) patterns of fibrosing lung disease in the setting of idiopathic pulmonary fibrosis (IPF): definite UIP (traction bronchiectasis and honeycombing), possible UIP and inconsistent with UIP. The distinction between definite UIP and possible UIP in these to the presence or absence of honeycombing. Approved by the Ethics Committee.Quantitative variables are expressed as mean (SD) and dichotomous variables as percentages (%). The association between tobacco-UIP and FVC-UIP was studied using two Chi-square tests and the DLCO-UIP relationship with an exact Fisher test. Statistical analysis with SPSS version 21.Results:21 men and 36 women were included, with a mean age of 69 ± 10 years (mean ± SD), history of smoking (smokers 14%, non-smokers 43%, ex-smokers 42%). 83% were positive RF and 70% positive ACPA. Regarding the HRCT findings: 29 (50%) had a inconsistent with UIP pattern and 28 (49%) had an UIP pattern (45% defined, 3% possible). Of the UIP patients, 14 (50%) had a smoking relationship (35% ex-smokers, 25% smokers) and 15 were male (53%). Of the sample analyzed, 8% (5 patients) have died, all ex-smoking men, the UIP pattern being the most frequent found (4 UIP, 1 inconsistent with UIP).No statistical association was observed between patients with exposure to tobacco and the UIP pattern (p = 0.438), nor among patients with baseline FVC <80% and UIP (p = 0.432) and also among patients with baseline DLCO <40% and UIP pattern (p = 0.459).Conclusion:Our results, in general, do not match what is published in the literature. Male sex, smoking exposure and fibrosing pattern (UIP) represent a worse prognosis for patients with ILD-RA. However, more studies are required to determine more precisely how these risk factors affect the disease.Disclosure of Interests:None declared

scholarly journals High-titer rheumatoid factor seropositivity predicts mediastinal lymphadenopathy and mortality in rheumatoid arthritis-related interstitial lung disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Albina Tyker ◽  
Iazsmin Bauer Ventura ◽  
Cathryn T. Lee ◽  
Rachel Strykowski ◽  
Nicole Garcia ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interstitial Lung Disease ◽  
Lung Function ◽  
Lung Disease ◽  
Rheumatoid Factor ◽  
Cox Regression ◽  
Mediastinal Lymph Node ◽  
High Titer ◽  
Mediastinal Lymphadenopathy ◽  
High Morbidity

AbstractRheumatoid arthritis-related interstitial lung disease (RA-ILD) is a common connective tissue disease-related ILD (CTD-ILD) associated with high morbidity and mortality. Although rheumatoid factor (RF) seropositivity is a risk factor for developing RA-ILD, the relationship between RF seropositivity, mediastinal lymph node (MLN) features, and disease progression is unknown. We aimed to determine if high-titer RF seropositivity predicted MLN features, lung function impairment, and mortality in RA-ILD. In this retrospective cohort study, we identified patients in the University of Chicago ILD registry with RA-ILD. We compared demographic characteristics, serologic data, MLN size, count and location, and pulmonary function over 36 months among patients who had high-titer RF seropositivity (≥ 60 IU/ml) and those who did not. Survival analysis was performed using Cox regression modeling. Amongst 294 patients with CTD-ILD, available chest computed tomography (CT) imaging and serologic data, we identified 70 patients with RA-ILD. Compared to RA-ILD patients with low-titer RF, RA-ILD patients with high-titer RF had lower baseline forced vital capacity (71% vs. 63%; P = 0.045), elevated anti-cyclic citrullinated peptide titer (122 vs. 201; P = 0.001), CT honeycombing (50% vs. 80%; P = 0.008), and higher number of MLN ≥ 10 mm (36% vs. 76%; P = 0.005). Lung function decline over 36 months did not differ between groups. Primary outcomes of death or lung transplant occurred more frequently in the high-titer RF group (HR 2.8; 95% CI 1.1–6.8; P = 0.028). High-titer RF seropositivity was associated with MLN enlargement, CT honeycombing, and decreased transplant-free survival. RF titer may be a useful prognostic marker for stratifying patients by pulmonary disease activity and mortality risk.

Clinical, laboratory and instrumental characteristics in patients with rheumatoid arthritis with "ground glass opacity" computed tomographic symptom of interstitial lung disease

2015 ◽  
Vol 9 (1) ◽  
pp. 0-0
Author(s):  
Бестаев ◽  
D. Bestaev ◽  
Божьева ◽  
L. Bozheva
Keyword(s):  
Rheumatoid Arthritis ◽  
Computed Tomography ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Clinical Laboratory ◽  
Ground Glass Opacity ◽  
Ground Glass ◽  
Unknown Etiology ◽  
Lung Pathology ◽  
Average Life Expectancy

Rheumatoid arthritis is an inflammatory rheumatic disease with unknown etiology characterized by symmetric, chronic and erosive arthritis (synovitis) of the peripheral joints and systemic inflammatory involvement of the viscera. Lung pathology, including interstitial lung disease, is one of the common extra-articular manifestations at the гheumatoid arthritis. The leading diagnosis method of interstitial lung disease is a computed tomography high resolution, which allows to identifying interstitial lung changes in 70% of the cases. The study of prognosis in patients with rheumatoid arthritis interstitial lung disease has been the subject of several studies in the past decade. In most studies it was stated that the average life expectancy from diagnosis is around 3 years. This work is devoted to study of interstitial lung disease as one of the most frequent extra-articular ma-nifestations of rheumatoid arthritis. The authors defined the significance of computed tomography high resolu-tion for the diagnosis of pulmonary interstitial lung changes at rheumatoid arthritis. They give comparative clini-cal and immunological, instrumental characteristics of rheumatoid arthritis patients with interstitial lung disease and without it. The role of smoking and positivity of anti-cyclic citrullinated peptide (anti-CCP) according to antibodies are determined as risk factors of interstitial lung disease development in patients with rheumatoid arthritis. The interrelation of the X-ray tomography symptom of interstitial lung disease &#34;ground glass opacity&#34; with the activity and duration of rheumatoid arthritis is revealed. &#34;Ground glass opacity&#34; symptom is associated with high index of DAS28 in patients with rheumatoid arthritis with interstitial lung disease.

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