FRI0048 Mortality and morbidity of rheumatoid arthritis-associated lung disease during a 10-year period: a longitudinal cohort study of 103 japanese patients

Background Subclinical and overt lung diseases associated with rheumatoid arthritis (RA-LD) are present in 30%–50% of the patients. Early and effective intervention improved joint prognosis in RA. By contrast, lung complications are still the primary contributors to premature deaths in patients with RA. Lung complication in RA can be due to a variety of conditions. However, the individual mortality and progression of pulmonary manifestations have not been established. Objectives To clarify the prognostic factors of patients with RA-LD. Methods This cohort study comprised RA patients examined with lung high resolution CT (HRCT) scan regardless of respiratory symptoms from 2005 to 2009. Respiratory diagnoses were certified by pulmonologists. The patients were reassessed by one follow-up CT scan after 10 years. All patients were evaluated for the events defined as death, serious infections and others (admission due to bone fracture, and ischaemic heart disease) from 2005 to 2017. Mortality risks were assessed using Kaplan-Meier method. Results Clinical features of 103 (82 females) patients are shown in table 1. Thirty-one (30%) had RA-LD including 18 interstitial pneumonia and 13 bronchiolitis at the start of observation. Mean observation period was 110 months. During observation, patients without RA-LD (non RA-LD) never developed new lung complications. The 10 year survival rate (SR) was 92% (mortality rate was 1.3 per 100 patient-years) and the 10 year event free survival rate (EFS) 69% (event rate was 4.8 per 100 patient-years). SR in RA-LD was significantly low compared with non RA-LD (p=0.008) (figure 1). EFS in RA-LD was significantly lower than in non RA-LD (p=0.03). Types of lung complication didn’t correlate with high mortality. The causes of death comprised infection (55%), malignant tumour (27%), interstitial pneumonia (9%), and the others (9%). The adverse events included infection (41%), malignant tumour (21%), bone fracture (15%), cardiac disease (10%), and severe drug eruption including Steven-Johnson syndrome (13%). Univariate analysis showed that infection (p Conclusions RA-LD is a serious complication in RA, and related with a high mortality. Disclosure of Interest None declared