Figures
- FIGURE 1
Identification of studies flow diagram. #: Some studies addressed more than one connective tissue disease (CTD). IIM: idiopathic inflammatory myositis; ILD: interstitial lung disease; MCTD: mixed connective tissue disease; pSS: primary Sjögren's syndrome; RA: rheumatoid arthritis; SLE: systemic lupus erythematosus; SSc: systemic sclerosis; UCTD: undifferentiated connective tissue disease.
- FIGURE 2
Pooled prevalence of interstitial lung disease (ILD) in patients with connective tissue disease.
- FIGURE 3
Metaregression of potential factors influencing heterogeneity of reported prevalence of interstitial lung disease (ILD) within each connective tissue disease. a) Rheumatoid arthritis (RA), b–d) systemic sclerosis (SSc), e–f) idiopathic inflammatory myositis (IIM). There were insufficient data to support meta-regression for primary Sjögren's syndrome, systemic lupus erythematosus, mixed connective tissue disease and undifferentiated connective tissue disease.
- FIGURE 4
Pooled prevalence of interstitial lung disease patterns by connective tissue disease. Insufficient data were available to support subdivision of non-usual interstitial pneumonia (UIP) patterns in undifferentiated connective tissue disease. LIP: lymphocytic interstitial pneumonia; NSIP: nonspecific interstitial pneumonia; other: other and undifferentiated; OP: organising pneumonia.
Tables
- TABLE 1
Risk factors for development of interstitial lung disease (ILD)
Demographic Clinical Serologic RA Older age#
Older age of RA onset#
Male sex#
Female sex#
Longer RA duration
Shorter RA duration#Morning stiffness
Erosive arthritis
DAS28 score#
BMI >30 kg·m−2#
Smoking history#RF positive#
RF titre#
Anti-CCP positive#
Anti-CCP titre#
ESR#
CRP
LDH#SSc Older age
Male sex
Female sex
Black race#
Longer SSc duration#
Shorter SSc durationDiffuse cutaneous subtype#
Higher MRSS
Digital ulcers#
History of renal crisis
GI system involvement#
Myopathy
Ever smoker (lower ILD)Anti-Scl70#
Anti-centromere absent#
Anti-SSA positive
ESR#
CRP
Hb <13.0 g·dL−1Idiopathic inflammatory myositis Black race Polymyositis (lower ILD)
Anti-synthetase syndrome
Clinically amyopathic
Mechanic's hands#
Absence of malignancy
Arthralgia/arthritis
Lateral hip erythema#Anti-synthetase antibody
Anti-Jo1
Anti-PL7/12
Anti-MDA5#
ANA
Anti-SSA
Anti-Ro52
Anti-NXP2, Tiff, Mi2 (lower ILD)
ESR#
CRP
Lower HbPrimary Sjögren syndrome Older age#
Older age of onset
Male sex#
Longer disease durationRaynaud's phenomenon
Oral ulcer
Salivary gland biopsy focus score ≥4#ANA
Anti-SSA
Anti-SSB
Anti-Ro52
ANCA positive
ESR
CRPMixed connective tissue disease Raynaud's phenomenon#
Dysphagia#
Never arthritisAnti-U1 RNP >200 All risk factors are reported as the state associated with an increased risk of ILD (e.g. “Older age” indicates higher ILD prevalence with older age). Some studies reported opposite effects (e.g. male and female sex were each identified as a risk factor for ILD in different studies of rheumatoid arthritis (RA)). Insufficient data were available for systemic lupus erythematosus and undifferentiated connective tissue disease. Italic: ≥5 studies. #: adjusted analysis. ANA: antinuclear antibody; ANCA: antineutrophil cytoplasmic antibody; BMI: body mass index; CCP: cyclic citrullinated peptide; CRP: c-reactive protein; DAS: disease activity score; ESR: erythrocyte sedimentation rate; GI: gastrointestinal; Hb: haemoglobin; LDH: lactate dehydrogenase; MDA5: melanoma differentiation-associated gene 5; MRSS: modified Rodnan skin score; RF: rheumatoid factor; RNP: ribonucleoprotein; SSA/B: Sjögren's syndrome type A/B; SSc: systemic sclerosis.
Supplementary Material
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Supplementary material ERR-0210-2022.SUPPLEMENT
