ArticleBMJ open respiratory research2026
Functional, radiological and survival outcomes in rheumatoid arthritis-associated interstitial lung disease: 24-month results from the BERTHA prospective cohort.
Article in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04136223 (BERTHA Study), which is not on this map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
BERTHA Study: Rheumatoid Arthritis-Associated Interstitial Lung Disease: Characterization of Lung Disease Progression. A Multicenter, Observational Study
Who cites it
1 citing paper in PubMed.
- A syndromic framework for progressive pulmonary fibrosis.Respiratory research · 2026Review
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Authors and funding
29 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRheumatoid arthritis-associated interstitial lung disease (RA-ILD) is heterogeneous. Forced vital capacity (FVC) decline and high-resolution CT (HRCT) pattern are widely used as prognostic markers, but the natural history of RA-ILD identified in rheumatology clinics, particularly in mild disease, remains insufficiently described.
methodsWe conducted a prospective, multicentre cohort study across three Brazilian centres. Adults with RA-ILD were followed every 6 months for 24 months. Pulmonary function tests, HRCT, 6 min walk test and King's Brief Interstitial Lung Disease health-related quality-of-life questionnaire were performed at baseline, 12 and 24 months. Blood biomarkers were assessed at baseline, 6 and 18 months. HRCT scans were independently reviewed by two chest radiologists and analysed using densitometry-based quantitative CT (QCT). Pulmonary fibrosis was qualitatively defined by unequivocal traction bronchiectasis and/or honeycombing on HRCT.
resultsNinety-five subjects were included (mean age 63±10 years; 81% female). Pulmonary fibrosis was present in 80%, although only 20% were classified as definite or probable usual interstitial pneumonia (κ=0.52). Individuals with fibrosis had lower FVC (75%±17 vs 86%±15, p=0.02) and worse QCT measures (%high-attenuation areas -600 to -250 HU 12.1±6.6 vs 5.5±0.8, p<0.001; lung volume 3407±958 mL vs 4077±923 mL, p=0.015). In 24 months, FVC and QCT measures remained stable. Eight subjects (8%) died. Deaths were not preceded by measurable functional or radiological decline. Health-related quality-of-life scores and blood biomarkers remained unchanged.
conclusionsIn this predominantly mild RA-ILD cohort, pulmonary function and QCT metrics remained stable over 2 years despite an 8% mortality rate. The absence of preceding decline in conventional prognostic markers suggests potential limitations of current monitoring strategies, although our findings should be interpreted as hypothesis-generating. TRIAL REGISTRATION NUMBER: NCT04136223.
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