25rhk135 10.3205/25rhk135 urn:nbn:de:0183-25rhk1356 Meeting Abstract Fischinger Fischinger Carina C

LMU University Hospital Munich, Department of Pneumology, Munich

author Popp Popp Florian F

MVZ für Rheumatologie Dr. M. Welcker, Planegg

author Reichenberger Reichenberger Frank F

Augustinum Hospital Munich, Department of Pneumology, Munich Clinic of Pulmonary Medicine, Seefeld-Hechendorf

author Kneidinger Kneidinger Nikolaus N

LMU University Hospital Munich, Department of Pneumology, Munich Medical University Graz, Department of Pneumology, Graz

author Tiede Tiede Robin R

LMU University Hospital Munich, Department of Pneumology, Munich

author von Wulffen von Wulffen Werner W

Augustinum Hospital Munich, Department of Pneumology, Munich

author Welcker Welcker Martin M

MVZ für Rheumatologie Dr. M. Welcker, Planegg M.B.W.-Welcker GbR, Rheumatologie, Planegg

author German Medical Science GMS Publishing House

Düsseldorf

610 20250917 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0627 135 Deutsche Gesellschaft für Rheumatologie Deutsche Gesellschaft für Orthopädische Rheumatologie 53. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 39. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh) Deutscher Rheumatologiekongress 2025 Rheumatoide Arthritis Wiesbaden 20250917 20250920 RA.08 TextIntroduction: Rheumatoid Arthritis (RA), in particular Rheumafactor- and ACPA-positive RA, is associated with a significantly higher risk for pulmonary and cardiovascular comorbidities , .In order to achieve a better prognosis as well as a better therapeutic outcome early detection of pulmonary comorbidities, in particular of interstitial lung disease (ILD), is crucial. Despite its great relevance, no recommendations for a screening protocol are not yet issued.Methods: In this study, we enrolled 214 consecutive patients with a confirmed diagnosis of seropositive and ACPA-positive RA, who exhibited no symptoms or prior history of cardiopulmonary disease. To screen for pulmonary, pleural, or vascular manifestations of RA, we utilized noninvasive, radiation-free methods, including pulmonary function tests (PFT), cardiopulmonary exercise testing (CPET), echocardiography, and pleuro-pulmonary transthoracic ultrasound (LUS). The study was divided into two phases.Results: 203 patients (mean age 59,2 ±12,2 years, 76% female, 16,7% current smokers and 26,6% previous smokers) were examined.The average duration of disease in the overall cohort is 8.3 (±7.1) years, with 32% of patients (n=64) suffering from an erosive course of RA.In total, the disease activity of the cohort is in remission, regardless of the method used to measure disease activity (DAS28CRP 2.3, CDAI 5.7, SDAI 6.2, BSG 16.4, CRP 4.5).In the pulmonary function test, 81 patients (42%) showed abnormalities. With a mean FVC of 97.3%, the comparison of the ILD-group vs. non-ILD-group showed differences in DLCOc% (68.2%±13.5 vs. 82.4%±14.9). Sonographic changes were seen in 107 patients (52.7%), with 29% (n=58) showing typical LUS pattern compatible with ILD such as B-lines, comet tail artifacts and pleural irregularities3.With the parallel occurrence of characteristic alterations in LUS as well as additional changes in PFT, ILD was suspected, affecting 15.1% of the patients (n=30).Secondary findings included pleural consolidation suspected of malignancy and pleural effusion on LUS, severe aortic stenosis in the context of a bicuspid aortic valve, and severely impaired diffusion capacity due to pulmonary emphysema and obstructive lung disease.Conclusion: In conclusion, this novel screening protocol including lung sonography for RA patients enables the early detection of pulmonary manifestation of RA and various other cardiopulmonary comorbidities, revealing a significant number of asymptomatic patients.Figure 1 Table 1 Drosos GC Vedder D Houben E Boekel L Atzeni F Badreh S Boumpas DT Brodin N Bruce IN González-Gay MÁ Jacobsen S Kerekes G Marchiori F Mukhtyar C Ramos-Casals M Sattar N Schreiber K Sciascia S Svenungsson E Szekanecz Z Tausche AK Tyndall A van Halm V Voskuyl A Macfarlane GJ Ward MM Nurmohamed MT Tektonidou MG EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome 2022 Ann Rheum Dis 768-79 Drosos GC, Vedder D, Houben E, Boekel L, Atzeni F, Badreh S, Boumpas DT, Brodin N, Bruce IN, González-Gay MÁ, Jacobsen S, Kerekes G, Marchiori F, Mukhtyar C, Ramos-Casals M, Sattar N, Schreiber K, Sciascia S, Svenungsson E, Szekanecz Z, Tausche AK, Tyndall A, van Halm V, Voskuyl A, Macfarlane GJ, Ward MM, Nurmohamed MT, Tektonidou MG. EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome. Ann Rheum Dis. 2022 Jun;81(6):768-79. DOI: 10.1136/annrheumdis-2021-221733 http://dx.doi.org/10.1136/annrheumdis-2021-221733 Kadura S Raghu G Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management 2021 Eur Respir Rev 210011 Kadura S, Raghu G. Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management. Eur Respir Rev. 2021 Jun 23;30(160):210011. DOI: 10.1183/16000617.0011-2021 https://doi.org/10.1183/16000617.0011-2021 Gargani L Lung ultrasound: a new tool for the cardiologist 2011 Cardiovasc Ultrasound 6 Gargani L. Lung ultrasound: a new tool for the cardiologist. Cardiovasc Ultrasound. 2011 Feb 27;9:6. DOI: 10.1186/1476-7120-9-6 http://dx.doi.org/10.1186/1476-7120-9-6 11

Table 1: Cohort description, first & second part of the study

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1 1 Figure 1: Scatterplot RA activity scores vs. FVC (%), first part of the study

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