RA-ILD: Tracking Function and CT
Conventional monitoring markers do not change before deaths in this predominantly mild cohort.
By
Kathryn Wighton
March 6, 2026
Clinical Scorecard: RA-ILD: Tracking Function and CT
At a Glance
Category Detail
Condition Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD) Key Mechanisms Pulmonary fibrosis characterized by traction bronchiectasis and/or honeycombing on high-resolution CT. Target Population Adult patients with rheumatoid arthritis meeting ACR criteria and confirmed ILD on CT. Care Setting Rheumatology clinics in Brazil.
Key Highlights
Stable pulmonary function and imaging measures over 24 months. 8% mortality rate observed, with deaths not preceded by measurable decline in FVC. 80% of patients had pulmonary fibrosis, but only 20% classified as definite/probable usual interstitial pneumonia. Densitometry-based CT measures showed no meaningful longitudinal change. 12% of patients improved, 69% remained stable, and 19% worsened at 24 months. Guideline-Based Recommendations
Diagnosis
Confirm ILD via high-resolution CT in patients meeting ACR criteria for RA. Management
Monitor pulmonary function tests and imaging at baseline, 12, and 24 months. Monitoring & Follow-up
Assess FVC, 6-minute walk distance, and quality-of-life at specified intervals. Risks
Mortality may occur without preceding functional decline or imaging progression. Patient & Prescribing Data
105 enrolled patients with RA-ILD, mean age 63 years, 81% female.
No lung transplantations occurred; deaths were often associated with pulmonary infections.
Clinical Best Practices
Utilize a centralized qualitative imaging review for consistency. Consider the stability of pulmonary function in management decisions. Recognize the potential for mortality without prior functional decline. References
