Screening for rheumatoid arthritis-associated interstitial lung disease—a Delphi-based consensus statement
Klaus Hackner, Lisa Hütter, Holger Flick, Michael Grohs, Kastriot Kastrati, Hans P. Kiener, David Lang, Birgit Mosheimer-Feistritzer, Helmut Prosch, Eva Rath, Otmar Schindler, Florentine Moazedi‐Fürst
Abstract
OBJECTIVE: Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a major driver of premature mortality in patients with rheumatoid arthritis (RA). Detection of RA-ILD is crucial but requires awareness among the treating physicians. To date, however, there is no international recommendation concerning screening for ILD in RA patients. METHODS: After a systematic literature review, the modified Delphi technique in combination with the nominal group technique was used to provide a Delphi consensus statement elaborated by an expert panel of pneumonologists, rheumatologists, and a radiologist. Based on the available evidence, several clusters of questions were defined and discussed until consent was reached. RESULTS: A screening algorithm for ILD in patients with RA based on clinical signs, respiratory symptoms, and risk factors has been developed. Further, the recommendations address diagnostic tools for RA-ILD and the follow-up of RA patients qualifying for ILD screening.