AB0194 PROGRESSION OF RHEUMATOID PULMONARY NODULES: WHAT ARE THE PREDICTIVE FACTORS?

Background Pulmonary rheumatoid nodule(RPN) is an serious extraarticular manifestation of arthritis (RA). The clinical features and activity the RA, used DMARDs characteristics nodule may affect progression RPN. [1] Objectives To identify PRN factors affecting its progression. Methods In this study, 4117 patients with RA according to ICD-10 code from hospital database who had at least one computed tomography (CT) were identified. diagnosis confirmed by examining medical files (history, physical examination, radiography laboratory evaluations). Then, chest CTs examined experienced radiologist. classify pulmonary nodules as ‘’pulmonary nodule’’, following inclusion exclusion criteria used; For inclusion: 1) changing dimension on follow-up, 2) At two different dimensions, 3) Cavitary any CT. exclusion: Solitary OR all ≤ 5mm without follow-up no change follow-up. Biggest was named dominant nodule. grouped status Progression defined growth or new formation. Results Of 680 in CT, 208 (30.6%) classified having PRN. these patients, 135 control CT for included study. median disease duration baseline 6.74(0.1-33.9) years. Before 59 (43.7%) recieving methotrexate it discontinued 22 (37.2%) after RPN detection. 39 (28.9%) their final compared baseline. between 1.58(0.04-33.81)years. Anti-CCP positivitiy(OR 3.39, %95 CI 1.15-9.94), usage bDMARDs last (OR 2.48, 1.1-5.5), cavitation 3.31, 1.5-7.4) diameter 1.03, 1.00-1.07) significantly assosiated Table 1. Progressed (n=39) Non-progressed, n=96 p Female, n(%) 26/39(66.7) 63(65.6) 0.5 Age time med(min-max) 58.3(37.6-79.9) 60(19.5-83.1) 0.4 Time diagnoses RPN, years, 8.92(0.4-24.4) 6.61(0.1-33.9) 0.7 Disease duration, 13.1(3.8-32.8) 14.6(0.6-41.2) 0.9 Follow up CT,months, 20.1(0.4-124.8) 18.6(0.95-405) 0.2 RF 24/38(63.1) 58/91(63.7) CCP 24/29(82.7 ) 41/70(58.5 0.017 Positivite 31/38(81.5) 68/94(72.3) 0.18 Smoking 10/18(55.5) 22/36(61.1) 0.48 Presence ILD 14/37(37.8) 30/92(32.6) 0.3 Pleural effusion 8/37(21.6) 10/85(11.8) 0.1 thickening 3/38(7.9) 8/87(9.2) Treatments 0.02 csDMARDs 16(41) 75(78.1) bDMARDs+csDMARDs 26(66.6) 21(21.8) Anti-TNF drugs 9(23) 5(5.2) Non-antiTNF 22(56.4) 23(25.5) Diameter nodule, med(min-max 6.29(2.7-26.1 5.27(3-16 0.03 Number baseline, 8.5(3-82 7(3-40 0.028 Cavitation, 19(48.7 21(21.8 0.002 Calcification, 13(33.3) 26(27) Anti-CCP: Anti- Cyclic citrullinated peptide, RF: Rheumatoid Factor, ILD: interstitial lung disease, csDMARDs: conventional synthetic Modifying Anti-Rheumatic Drugs) Conclusion Our study shows that there are multiple predict Especially presence cavitary seropositivity important.Although clinicians tend discontinue MTX when detected, not associated Reference [1]Karadeniz, H., et al., Treatment biologic adversely patients. Eur J Rheumatol, 2022. 9 (2): p. 75-81. Acknowledgements: NIL. Disclosure Interests None Declared.