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Lung ultrasound predicts progression of interstitial lung abnormalities in rheumatoid arthritis

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Lung ultrasound predicts progression of interstitial lung abnormalities in rheumatoid arthritis

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Lung ultrasound (LUS) can predict radiologic progression of interstitial lung abnormalities (ILAs) in patients with rheumatoid arthritis (RA), according to a study published in the November issue of Arthritis & Rheumatology.

Marie Vermant, M.D., Ph.D., from KU Leuven in Belgium, and colleagues examined the role of LUS in monitoring radiologic progression and the development of new ILAs among patients with RA. Participants underwent high-resolution computed tomography (HRCT), pulmonary function tests (PFTs), symptom assessment, and LUS at baseline and after 12 to 18 months. A 72-zone protocol was used to quantify B-lines. Radiologic changes across longitudinal HRCTs were scored. To predict HRCT progression, six multivariable logistic regression models were built using combinations of LUS parameters, PFTs, symptoms, and clinical characteristics.

Overall, 81 patients completed follow-up HRCT and 77 underwent per-protocol LUS. The researchers observed radiologic progression in 31% of patients. There was a significant association between an increase in B-lines and radiologic progression; a linear trend was confirmed.

Both baseline B-lines and change in B-lines over time significantly predicted progression in a multivariable analysis (area under the curve [AUC], 0.78). The model fit remained similar when combining LUS and change in diffusing capacity for carbon monoxide (AUC, 0.82) and outperformed symptom scores and PFTs (AUCs, 0.58 and 0.59, respectively).

"LUS may aid in detecting radiologic progression and the appearance of new development of ILAs," the authors write.


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