PROGRESSIVE FIBROSING INTERSTITIAL LUNG DISEASE IN RHEUMATOID ARTHRITIS

<bold>Introduction:</bold> Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) affects between 11.9% and 55.7% of patients with rheumatoid arthritis. Some patients develop progressive pulmonary fibrosis (PPF) according to the ARS/ERS/ALAT 2022 clinical guidelines, with worsening of respiratory symptoms, lung function and radiological findings during follow-up. The radiological pattern of usual interstitial pneumonia (UIP), high levels of antibodies against citrullinated peptides (ACPAs), degree of DLCO decrease and extensive distribution of radiological fibrotic changes have been described in the literature as predictive factors for disease progression. The aim of this study was to analyse the clinical, functional, analytical and radiological characteristics of patients with RA-ILD and to determine the differences between patients with and without PPF. <bold>Methods:</bold> Retrospective study of patients with RA-ILD followed at the Vall d'Hebron Hospital outpatient clinic. Epidemiological, clinical, analytical, radiological and pulmonary function data were analysed and characterised by meeting or not meeting the PPF criteria. <bold>Results:</bold> 28 patients were included. No statistically significant differences were observed between the PPF and non-PPF groups with regard to gender, smoking, family history, ACPAs and mortality. The presence of PPF was associated with a radiological pattern of NIU (72% vs. 28%, p-value 0.023) and a higher need for lung transplantation (64% vs. 0%, p-value = 0.01). ' <bold>Conclusions:</bold> RA-ILD patients with PPF were significantly associated with a radiological NIU pattern and a higher need for lung transplantation. This confirms the importance of early evaluation for lung transplantation in these patients.