Exploring pulmonary involvement in newly diagnosed rheumatoid arthritis, and psoriatic arthritis: a single center study

• Published in: Rheumatology international Vol. 44; no. 10; pp. 1975 - 1986
• Main Authors: Schäfer, Valentin Sebastian, Winter, Lone, Skowasch, Dirk, Bauer, Claus-Jürgen, Pizarro, Carmen, Weber, Marcel, Kütting, Daniel, Behning, Charlotte, Brossart, Peter, Petzinna, Simon Michael
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2024; Springer Nature B.V
• Subjects: Adult; Aged; Arthritis, Psoriatic - diagnostic imaging; Arthritis, Psoriatic - epidemiology; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - epidemiology; Asymptomatic; Case-Control Studies; Cross-Sectional Studies; Female; Humans; Lung - diagnostic imaging; Lung - physiopathology; Lung Diseases - diagnostic imaging; Lung Diseases - epidemiology; Lung Diseases - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Observational Research; Prevalence; Psoriatic arthritis; Respiratory Function Tests; Rheumatoid arthritis; Rheumatology; Risk Factors; Diagnostics, epidemiology; Extra-articular manifestation; Rheumatoid arthritis; Imaging; Pulmonary involvement; Psoriatic arthritis
• ISSN: 1437-160X; 0172-8172; 1437-160X
• DOI: 10.1007/s00296-024-05685-3

Objectives This cross-sectional study aimed to determine the prevalence, manifestation, and risk factors of pulmonary involvement in newly diagnosed, untreated rheumatoid arthritis (RA) and psoriatic arthritis (PsA) patients, and to evaluate the efficacy of various diagnostic tools in screening for pulmonary involvement. Methods Untreated, newly diagnosed patients with RA and PsA underwent an extensive multimodal diagnostic approach including clinical and laboratory assessment, pulmonary function tests, and chest radiography. Results We recruited 50 arthritis patients (26 RA, 24 PsA) and 26 control subjects. Respiratory symptoms were found in 36.0 % of arthritis patients and 11.5 % of controls (p = 0.031). Pathologically reduced breathing width (< 3.0 cm) was significantly more common in arthritis patients (64.0 %) than in controls (23.1 %) (p < 0.001). Pulmonary function test results did not differ significantly between groups. Chest radiography revealed pulmonary involvement in 37.0 % of arthritis patients, higher in RA (50.0 %) than in PsA (22.7 %). Notably, only 35.3 % of arthritis patients with radiographic pulmonary involvement were symptomatic, with 64.7 % being asymptomatic. Radiographic pulmonary involvement was associated with advanced age (p = 0.002) and increased rheumatoid factor levels (p = 0.024). Conclusion Our research underscores the significant prevalence of largely asymptomatic pulmonary involvement in newly diagnosed RA and PsA patients. These findings highlight the importance of an early, multidisciplinary screening approach, particularly for high-risk individuals. Further large-scale studies are needed to develop comprehensive screening protocols to improve early detection and treatment of pulmonary involvement in arthritis.