How Rheumatoid Arthritis Affects the Lungs
Interstitial Lung Disease
Rheumatoid arthritis–associated interstitial lung disease, or RA-ILD, is one of the most serious lung complications for people with rheumatoid arthritis. This illness can be hard to detect, but occurs when lung tissue becomes inflamed and eventually scarred. Here’s what we do know:
- Risk Factors Men are at higher risk than women for this disease. Although nonsmokers can and do develop RA-ILD, smoking seems to increase risk.
- Symptoms RA-ILD may cause breathlessness and dry cough, but in many cases it causes no symptoms at all, making early detection difficult.
- Treatment More research is still needed to find effective treatment. “This is a difficult disease to treat,” Mody says. According to a review published in March 2015 in the journal European Respiratory Review, recent studies have looked at the drug Rituxan (rituximab) for the treatment of RA-ILD, but the results have been conflicting and it’s not clear whether it improves or worsens the condition. Some other drugs, like azathioprine (Azasan, Imuran), cyclosporine (Gengraf, Neoral), and cyclophosphamide (Cytoxan), are used to treat RA-ILD.
Inflammation, like the kind caused by RA-ILD, can lead to pulmonary fibrosis, or permanent scarring of the respiratory tissues. This can cause shortness of breath, since healthy air sacs are replaced by scar tissue. Supplemental oxygen can help make breathing easier, but will not reverse the damage done by pulmonary fibrosis.
Unfortunately, Trexall (methotrexate), a medication often used to treat rheumatoid arthritis, is associated with the development of pulmonary fibrosis. If you take this drug, your doctor should monitor your respiratory status especially closely.