Interstitial lung disease (ILD), a significant complication among patients with rheumatoid arthritis (RA), has a global prevalence of 21.38%, with higher rates observed in regions with lower socioeconomic status and among smokers, according to a study presented at ACR Convergence in Washington, DC.

Hari Prasanna, MD, and colleagues from the University of Western Australia in Canning Vale, Western Australia, Australia, noted in a poster presentation that the global prevalence and associated risk factors for RA-ILD remain poorly understood. Using population-based data, the investigators set out to estimate the global pooled prevalence and explore the impact of geography, socioeconomic status, smoking, and disease-modifying antirheumatic drug (DMARD) use on its prevalence.

They conducted a systematic review and meta-analysis of studies published between January 1980 and February 2024. The study adhered to PRISMA 2020 and Joanna-Briggs Institute guidelines, screening studies from Medline, EMBASE, Cinahl, and other databases. Quality assessment was performed using the Hoy et al. risk of bias tool, and a random-effects meta-analysis model was used to calculate the pooled prevalence of RA-ILD. Subgroup and sensitivity analyses were performed to assess heterogeneity, and meta-regression was used to identify potential risk factors.

A total of 33 studies, including 14,281 patients (2371 with RA-ILD), were included in the analysis. The global pooled prevalence of RA-ILD was 21.38% (95% CI: 15.42% - 28.86%), with significant heterogeneity (I² = 98%). The most common ILD patterns were usual interstitial pneumonia (11.01%) and nonspecific interstitial pneumonia (6.86%). Subgroup analyses revealed that Africa had the highest prevalence (38.15%), while Europe had the lowest (10.15%).

Socioeconomic status was inversely correlated with RA-ILD prevalence, with lower-income regions showing higher rates. Smokers and patients with higher DMARD use were also at increased risk for RA-ILD. Other factors, such as age, gender, and RA disease duration showed no clear association. Meta-regression indicated that the identified risk factors explained 46.38% of the heterogeneity.

The findings emphasize the need for early screening and intervention, particularly in high-risk populations. Further research is needed to better understand the heterogeneity of results and the underrepresentation of certain regions, including Oceania and low-income countries, the investigators concluded.

Reference:

Prasanna H, Inderjeeth C, Nossent J, and Almutairi K. 0477: The global prevalence of interstitial lung disease in patients with rheumatoid arthritis: A systematic review and meta-analysis. Presented at: American College of Rheumatology. November 14–19, 2024. Washington, DC.