Thousands of patients diagnosed with rheumatoid arthritis could be unknowingly living with a serious and potentially deadly lung disease, according to a new international expert consensus statement.
The condition, known as rheumatoid arthritis-associated interstitial lung disease (RA-ILD), can cause severe scarring and inflammation in the lungs, leading to breathing difficulties.
Rheumatoid arthritis, an autoimmune condition affecting over 400,000 people in the UK, is primarily recognized for its impact on joints. However, research published in The Lancet Respiratory Medicine indicates that it also carries a substantial risk of lung complications.
According to the study, one in six rheumatoid arthritis patients develop some form of lung abnormality, and one in ten are diagnosed with RA-ILD. Early detection and treatment are crucial, as the condition can be managed with medications that reduce inflammation, slow lung scarring, and help preserve breathing function. Common treatments include immunosuppressant drugs and anti-fibrotic medications.
If left untreated or diagnosed late, RA-ILD can lead to severe outcomes and can ultimately be fatal.
Symptoms to watch for include a persistent, unexplained dry cough, shortness of breath during physical activity, fatigue, and general weakness. Rarer signs may include crackling sounds in the lungs, finger and toe clubbing, and a hoarse voice.
Several factors increase the risk of developing RA-ILD. These include being male, being over the age of 60, and having a history of smoking. More severe symptoms of rheumatoid arthritis itself can also contribute to the development of the lung disease.
Experts are now calling for increased screening for RA-ILD among rheumatoid arthritis patients who meet high-risk criteria. "These recommendations provide practical guidance to help clinicians identify lung disease earlier, monitor patients more effectively and determine when treatment may be appropriate," said Dr. Joshua Solomon, lead author of the study and director of interstitial lung disease at National Jewish Health. Early intervention can significantly improve patient outcomes and quality of life.