Evaluation and management of pulmonary complications in rheumatoid arthritis

Abstract

The treatment of rheumatoid arthritis（RA）has made great strides, and the majority of patients now achieve clinical remission or low disease activity, resulting in prevention of joint damage, maintenance of quality of life, and improvement of long-term outcomes. To maximize therapeutic effects, it is essential to exert a treat-to-target strategy by adjusting use of disease-modifying anti-rheumatic drugs timely and appropriately, but ideal treatment is often prevented by complications and/or comorbidities. In RA patients, respiratory conditions are the most common comorbidities, and include extra-articular manifestations such as interstitial lung disease and airway disease, respiratory tract infection, drug hypersensitivity, and malignancy. These respiratory complications are major causes of death, but also influence choices of disease-modifying anti-rheumatic drugs. Therefore, management of respiratory complications by appropriate risk assessment, monitoring, and intervention is the keys to successful treatment of RA.