title: Evolution of imaging findings, laboratory and functional parameters in rheumatoid arthritis patients after one year of treatment with anti-TNF-α agents.
abstract: OBJECTIVE
  To investigate the efficacy and safety of anti-TNF-α agent treatment compared to non-biologic DMARDs in rheumatoid arthritis patients.
  
  
  METHODS
  82 consecutive patients, 29 males, 53 females, aged 42-79, diagnosed with RA and suitable for anti-TNF-α treatment composed two study groups: 42 with pre-existing rheumatoid arthritis-related interstitial lung disease (RA-ILD) and 40 without RA-ILD. Respective control groups consisted of 44 patients with pre-existing RA-ILD and 44 patients without RA-ILD, treated with non-biologic DMARDs. All patients underwent chest high resolution computed tomography (HRCT), pulmonary function tests (PFTs) and peripheral blood biomarkers at baseline and after one year of treatment.
  
  
  RESULTS
  There was a significant decrease of air trapping extent and bronchial wall thickening after treatment in RA-ILD and RA-non ILD study groups (p<0.05). This was accompanied by a statistically significant improvement of maximum mid-expiratory flow (MMEF75-25), RV and RV/TLC in both study groups (p<0.05). In the RA-ILD study group ILD extent scores remained unchanged after anti-TNF-α treatment. None of the RA-non ILD group developed new-onset ILD. In both RA-ILD and RA-non ILD control groups, HRCT findings and PFTs did not differ significantly at the one-year follow-up study. Methotrexate (MTX) regression analysis showed in both RA-ILD study and control groups a negative correlation between MTX dose and ILD extent score at one-year and between MTX dose and air trapping extent at baseline and after one year of treatment.
  
  
  CONCLUSIONS
  Anti-TNF-α treatment, in contrast to non-biologic DMARDs, there was an improvement of small airways disease. There was no new-onset ILD or exacerbation of preexisting-ILD, especially in patients treated with anti-TNF-α agents, supporting the efficacy and favourable safety profile of this treatment in RA patients.
authors.affiliation: Department of Radiology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece. edetorakis@hotmail.com.
authors.forename: Efstathios E
authors.initials: EE
authors.lastname: Detorakis
authors.affiliation: Department of Radiology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Magkanas
authors.affiliation: Department of Thoracic Medicine and Laboratory of Molecular and Cellular Pneumonology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.
authors.forename: Ismini
authors.initials: I
authors.lastname: Lasithiotaki
authors.affiliation: Department of Rheumatology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.
authors.forename: Prodromos
authors.initials: P
authors.lastname: Sidiropoulos
authors.affiliation: Department of Rheumatology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.
authors.forename: Dimitrios T
authors.initials: DT
authors.lastname: Boumpas
authors.affiliation: Department of Radiology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Gourtsoyiannis
authors.affiliation: Department of Thoracic Medicine and Laboratory of Molecular and Cellular Pneumonology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Antoniou
authors.affiliation: Department of Radiology, University Hospital of Heraklion, Medical School, University of Crete, Heraklion, Crete, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Raissaki
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D000069285:Infliximab / Q000627:therapeutic use*; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D006886:Hydroxychloroquine; D000069285:Infliximab; D008727:Methotrexate