Researchers to Discuss Advances in the Screening, Diagnosis, and Phenotyping of  ILD in Rheumatic Diseases

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a devastating illness that leads to poor outcomes, poor quality of life, and shortened survival. Meanwhile, there’s no standard way of knowing who to screen for RA-ILD. And while approximately 10% of people will have clinically significant RA-ILD, CT screening may estimate this to be closer to 40%. Complicating this further, 30% of RA patients have subclinical RA-ILD.

Advances in the screening, diagnosis, and phenotyping of RA-ILD will be discussed during Rheumatoid Arthritis-Associated Interstitial Lung Disease: Advances in Screening, Diagnosis and Patient Phenotyping. The session will take place on Sunday, Nov. 17, from 10–11:30 a.m. ET in Room 144ABC of the Walter E. Washington Convention Center and be available on demand within 48 hours for registered ACR Convergence 2024 participants.

Scott Matson, MD, Assistant Professor at the University of Kansas, will discuss molecular phenotyping of RA-ILD.

“Our lab is interested in leveraging systems biology, like proteomics, to understand molecular heterogeneity across systemic diseases like RA,” he said.

Dr. Matson is trying to leverage bronchoalveolar lavage (BAL), a fluid from the distal compartment of the lung, to understand how these RA-ILD patients’ lungs are different. He will present data from more than 100 patients’ samples, a third of whom had RA, scleroderma, or idiopathic pulmonary fibrosis (IPF).

“Our analysis is to try to understand the protein expression in each one of these patients’ lungs and to understand whether or not these patients with RA look more like scleroderma patients or IPF patients,” he said.

Bryant England, MD, PhD, Associate Professor of Rheumatology and Immunology at the University of Nebraska Medical Center, will discuss how new technology, such as the use of text mining of high-resolution computed tomography (HRCT) scans, can aid in the identification of RA-ILD. 

Clinicians are wondering how they can apply a new wave of tools, including artificial intelligence, text mining, and natural language processing, to medical care and electronic health records to enable them to do population health studies. These tools may also enable clinicians to think more broadly about their panel of patients and systematically identify trends.

“We want technology to help clinicians. This is not that technology is going to replace clinicians,” Dr. England said. “There’s no reason why we can’t take all these advancements in technology, science, and informatics and make those tools available to clinicians to help us do a better job.”

Vanessa Smith, MD, PhD, Head of Clinics at Ghent University Hospital and Full Professor of Rheumatology at Ghent University, Belgium, will discuss how novel tools, such as nailfold capillaroscopy, can improve the ability to identify certain rheumatic diseases in patients with ILD.

Nailfold capillaroscopy is a noninvasive, safe, and easy-to-use tool that has gained a major role in rheumatology in the evaluation of Raynaud’s phenomenon, Dr. Smith explained. In patients with Raynaud’s phenomenon, a scleroderma pattern on capillaroscopy can hint at diseases of the scleroderma spectrum, such as systemic sclerosis, inflammatory myopathies, and mixed connective tissue diseases.

Results of capillaroscopy may also aid complex discussions concerning diagnosis in multidisciplinary panels where ILD cases are being discussed, she noted. In ILD patients presenting with seronegative RA, a scleroderma pattern on capillaroscopy can hint at scleroderma spectrum diseases. Capillaroscopic results also may be one of the parameters pointing to interstitial disease with auto-immune features, Dr. Smith said.