A retrospective cohort study of patients with rheumatoid arthritis (RA) reveals that RA-associated lung disease (RA-LD), including both interstitial lung disease (RA-ILD) and bronchiectasis (RA-BR), is linked to significantly higher risks of hospitalization, emergency department (ED) visits, and intensive care unit (ICU) admissions compared to RA patients without lung involvement.

The study analyzed 221 patients with RA-LD (151 with RA-ILD and 70 with RA-BR) and 980 matched RA comparators without lung disease. Overall hospitalization occurred in 60% of patients with RA-LD versus 41% in the comparator group (p < 0.001), while respiratory hospitalizations were nearly four times more frequent (23% vs. 6%; p < 0.001). ICU admissions were also significantly higher in RA-LD (36% vs. 20%; p < 0.001).

“RA-LD was associated with higher risks of overall hospitalization, respiratory hospitalization, and ICU admissions than RA-no LD comparators,” investigators reported at ACR Convergence.

Time to first hospitalization was shorter for patients with RA-LD, with a median of 922 days compared to 1217 days in the RA-no LD group (p = 0.01). Time to first respiratory hospitalization was also significantly shorter (median 1588 vs. 2253 days; p = 0.009). Adjusted incidence rate ratios (IRRs) showed a 1.73-fold higher risk of overall hospitalization and a 5.13-fold higher risk of respiratory hospitalization in patients with RA-LD.

Importantly, the investigators reported, “RA-BR had a similarly elevated hospitalization risk as RA-ILD, illustrating an unreported unmet need in this population,” the authors noted.

These findings underscore the importance of early identification and proactive management of lung involvement in RA to mitigate acute care utilization and improve outcomes.

Reference
Zhang Q, Qi Y, Wang X, et al. Risk of hospitalization in patients with rheumatoid arthritis-associated interstitial lung disease or bronchiectasis: A matched cohort study [abstract]. Arthritis Rheumatol. 2025; 77 (suppl 9). https://acrabstracts.org/abstract/risk-of-hospitalization-in-patients-with-rheumatoid-arthritis-associated-interstitial-lung-disease-or-bronchiectasis-a-matched-cohort-study/