AI Article Synopsis
- - Interstitial lung disease (ILD) is a serious complication of rheumatoid arthritis (RA) that significantly impacts patient health, but effective screening and management strategies are still lacking.
- - Recent research underscores the need for improved identification of RA-ILD through accurate risk stratification and the exploration of peripheral biomarkers to support personalized medicine approaches.
- - There is a critical need for randomized trials to evaluate treatments for RA-ILD, especially immunomodulatory therapies, to develop evidence-based management strategies.
Article Abstract
Background: Interstitial lung disease (ILD) is an extra-articular manifestation of rheumatoid arthritis (RA) that causes substantial morbidity and mortality. Effective, evidence-based strategies to screen for, and manage, RA-ILD are lacking.
Objectives: Highlight recent research advances in, and further opportunities to improve, the identification and management of RA-ILD.
Findings: The goals of RA-ILD screening are early disease detection while avoiding unnecessary testing. Such an approach requires the ability to accurate risk stratify RA patients. With only a few recognized clinical risk factors for RA-ILD, a growing body of evidence on peripheral biomarkers for RA-ILD appears well suited to support a precision medicine approach. There is a paucity of evidence to guide management after RA-ILD diagnosis. While initial trials of antifibrotics have been conducted in RA-ILD and show the potential to slow the rate of pulmonary function decline, there have been no randomized trials of immunomodulatory therapies in RA-ILD. Supporting such trials, and addressing the barriers to conducting them, is a high priority.
Conclusion: Robust characterization of peripheral biomarkers in large, RA populations is essential to inform a precision medicine approach to RA-ILD identification. Randomized trials of treatments and treatment strategies that consider the systemic nature of RA-ILD are necessary to inform evidence-based RA-ILD treatment.
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| http://dx.doi.org/10.1016/j.semarthrit.2024.152578 | DOI Listing |
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