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Commentary: Ahead of the Curve |

A Roadmap to Promote Clinical and Translational Research in Rheumatoid Arthritis-Associated Interstitial Lung DiseaseRheumatoid Arthritis and Interstitial Lung Disease

Tracy J. Doyle, MD, MPH; Joyce S. Lee, MD; Paul F. Dellaripa, MD; James A. Lederer, PhD; Eric L. Matteson, MD, MPH; Aryeh Fischer, MD; Dana P. Ascherman, MD; Marilyn K. Glassberg, MD, FCCP; Jay H. Ryu, MD, FCCP; Sonye K. Danoff, MD, PhD, FCCP; Kevin K. Brown, MD, FCCP; Harold R. Collard, MD, FCCP; Ivan O. Rosas, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine (Drs Doyle and Rosas), the Division of Rheumatology, Immunology, and Allergy (Dr Dellaripa), and the Department of Surgery (Immunology) (Dr Lederer), Brigham and Women’s Hospital, Harvard Medical School, Boston, MA; the Division of Pulmonary and Critical Care Medicine (Drs Lee and Collard), University of California San Francisco School of Medicine, San Francisco, CA; the Division of Rheumatology (Dr Matteson), and the Division of Pulmonary and Critical Care Medicine (Dr Ryu), Mayo Clinic College of Medicine, Rochester, MN; the Division of Rheumatology (Dr Fischer), National Jewish Health and University of Colorado, Denver, CO; the Division of Rheumatology (Dr Ascherman), and the Division of Pulmonary Medicine (Dr Glassberg), University of Miami Miller School of Medicine, Miami, FL; the Division of Pulmonary and Critical Care Medicine (Dr Danoff), Johns Hopkins University School of Medicine, Baltimore, MD; the Autoimmune Lung Center and Interstitial Lung Disease Program (Dr Brown), National Jewish Health, Denver, CO; and the Lovelace Respiratory Research Institute (Dr Rosas), Albuquerque, NM.

Correspondence to: Ivan O. Rosas, MD, FCCP, Pulmonary and Critical Care Division, Department of Medicine, Brigham and Women’s Hospital, 75 Francis St, Thorn 826, Boston, MA 02115; e-mail: irosas@rics.bwh.harvard.edu


Drs Doyle and Lee contributed equally to this article.

Funding/Support: Dr Doyle is supported by the Harvard Catalyst MeRIT Program. Dr Lee is supported by the National Center for Advancing Translational Science, National Institutes of Health [Grant UCSF-CTI KL2TR000143]. Dr Ascherman is supported by the Department of Veterans Affairs. Dr Danoff is supported by the American College of Rheumatology Within Our Reach Grant. Dr Rosas is supported by the National Institutes of Health [Grant K23 HL087030].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(3):454-463. doi:10.1378/chest.13-2408
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Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting approximately 1.3 million adults in the United States. Approximately 10% of these individuals with RA have clinically evident interstitial lung disease (RA-ILD), and an additional one-third demonstrate subclinical ILD on chest CT scan. The risk of death for individuals with RA-ILD is three times higher than for patients with RA without ILD, with a median survival after ILD diagnosis of only 2.6 years. Despite the high prevalence and mortality of RA-ILD, little is known about its molecular features and its natural history. At present, we lack a standard validated approach to the definition, diagnosis, risk stratification, and management of RA-ILD. In this perspective, we discuss the importance of clinical and translational research and how ongoing research efforts can address important gaps in our knowledge over the next few years. Furthermore, recommendations are made to design multicenter collaborative studies that will expedite the development of clinical trials designed to decrease the significant morbidity and mortality associated with RA-ILD.

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