Harrington Robert, Harkins Patricia, Conway Richard
St. James's Hospital, LS9 7TF Dublin, Ireland.
J Clin Med. 2023 Oct 20;12(20):6657. doi: 10.3390/jcm12206657.
Rheumatoid arthritis (RA) is a chronic autoimmune multisystem inflammatory disease in which lung involvement is the most common extra-articular manifestation. Parenchymal lung involvement or interstitial lung disease (ILD) is a significant cause of morbidity and mortality and there is a paucity of evidence-based guidance on how to best treat RA-ILD. This review article aims to evaluate the evidence from cohort studies and best real word data from registries. Extensive discussion of the relative merits and drawbacks of glucocorticoids, various biologics, small molecules and anti-fibrotics is presented. The limited available guidelines in RA-ILD are also discussed and a rational treatment algorithm is offered.
类风湿关节炎（RA）是一种慢性自身免疫性多系统炎症性疾病，肺部受累是最常见的关节外表现。肺实质受累或间质性肺疾病（ILD）是发病和死亡的重要原因，关于如何最佳治疗类风湿关节炎相关间质性肺疾病（RA-ILD）的循证指南较少。这篇综述文章旨在评估队列研究的证据以及来自注册登记处的最佳真实世界数据。文中对糖皮质激素、各种生物制剂、小分子药物和抗纤维化药物的相对优缺点进行了广泛讨论。还讨论了RA-ILD中有限的现有指南，并提供了一种合理的治疗算法。
