Aktuelles zur RA-ILD

Zusammenfassung

Die interstitielle Lungenerkrankung bedingt durch eine rheumatoide Arthritis (RA-ILD) hat eine hohe klinische Relevanz. Sie beeinflusst nicht nur die Lebensqualität, sondern hat auch einen erheblichen Anteil an der Mortalität der rheumatoiden Arthritis. Eine RA-ILD kann sich mit allen radiologischen und histopathologischen Mustern präsentieren, die auch bei anderen interstitiellen Pneumonien auftreten. Dabei hat ein diffuser Alveolarschaden (diffuse alveolar damage, DAD), gefolgt von einer gewöhnlichen interstitiellen Pneumonie (usual interstital pneumonia, UIP) die schlechteste Prognose. Zudem hat eine akute Exazerbation der RA-ILD, welche zu jedem Zeitpunkt der Erkrankung auftreten kann, eine hohe Letalität. Ein Algorithmus zur Diagnostik und Therapie der RA-ILD ist ausstehend und wird in folgendem Beitrag thematisiert. Neben Immunsuppressiva und krankheitsmodifizierenden Medikamenten (disease-modifying antirheumatic drugs, DMARD) gewannen zuletzt Antifibrotika in der Therapie der RA-ILD an Bedeutung.

Abstract

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is of high clinical relevance. It not only affects the quality of life but also makes a significant contribution to the mortality rate of patients with rheumatoid arthritis. RA-ILD can present with all known radiological and histopathological patterns seen in other interstitial pneumonias. Among these pneumonias, diffuse alveolar damage (DAD), followed by usual interstitial pneumonia (UIP) has the worst prognosis. In addition, acute exacerbation of RA-ILD, which can occur at any time during the disease, is highly lethal. An algorithm for the diagnosis and treatment of RA-ILD is pending and will be addressed in the following article. In addition to immunosuppressants and disease-modifying antirheumatic drugs (DMARD), antifibrotics have recently gained importance in the therapy of RA-ILD.

Schlüsselwörter

Rheumatoide Arthritis - Interstitielle Lungenerkrankungen - Lungenfibrose - Autoimmune Entzündung

Keywords

Rheumatoid arthritis - interstitial lung diseases - lung fibrosis - autoimmune inflammation

Publication History

Received: 10 April 2022

Accepted after revision: 05 July 2022

Article published online:
14 September 2022

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