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Angelo L. Gaffo, MD; Graciela S. Alarcón, MD, MPH

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After carefully reading the article by Gochuico et al¹ on progressive preclinical interstitial lung disease (ILD) in rheumatoid arthritis (RA) in the January 28 issue of the Archives, we are concerned about the conclusions reached by the authors, namely that ILD is progressive in patients with RA, as the title of the article seems to indicate. If "progression" from subclinical to clinical disease is so frequent, we rheumatologists should be able to identify the clinical form more often than we do now. In fact, compared with years ago when the treatment of RA was much less aggressive than it is now, we saw extra-articular manifestations of RA in the lungs much more frequently than what we see nowadays. This perception is not unique to the United States or North America, where the cumulative incidence of pulmonary fibrosis after 30 years . . . [Full Text of this Article]

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Progressive Preclinical Interstitial Lung Disease in Rheumatoid Arthritis
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Arch Intern Med. 2008;168(2):159-166.
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