Implementation of a multimodal screening program for interstitial lung disease in rheumatoid arthritis patients

Interstitial lung disease associated to rheumatoid arthritis (RA-ILD) is an important extra-articular manifestation of rheumatoid arthritis (RA) in approximately 10% of patients. It has a poor prognosis; the median survival is only 3-10 years. At this moment, a systematic screening is lacking and the diagnosis is only made in an advanced stage, or during an acute exacerbation. The need for a cost-effective, safe and high-impact screening tool for detection of RA-ILD in an early stage arises. Recently antifibrotic therapy has shown to be effective in RA-ILD. It slows down disease progression, improves survival and diminishes the chances of an acute exacerbation. Combined with an early detection this could greatly impact survival and quality of life in RA-ILD patients and reduce the overall healthcare costs. In this project we propose a multimodal-screening program for RA-ILD. First, we will establish a large relevant patient population, looking at baseline characteristics and cross-sectionally determine the prevalence and incidence of RA-ILD in the University Hospitals Leuven. We will study the use of lung ultrasound as a screening tool. Second, we will determine genetic and molecular biomarkers in RA-ILD to propose an evidence-based rationale for our screening method. Third, we want to investigate the features at diagnosis for RA, including pulmonary function testing and chest imaging to provide possibilities for prospective cohorts.