Lung volumes and gas exchange were investigated prospectively in 96 patients with rheumatoid arthritis selected without regard to pulmonary disorders and treated with i.m. methotrexate (MTX) injections [mean weekly dose 13.0 mg (5th-95th percentile (5-95 PC) 7.6-20.8) ]. Individual changes over time during MTX treatment [mean duration 2.9 yr (5-95 PC 0.4-5.3) ] were assessed by regression analyses in each individual.
Forced vital capacity (FVC) remained stable in the majority of patients [mean annual change+0.8% (5-95 PC - 8.1 to+14.0) of calculated normal value]. In addition, transfer factor using the indicator gas CO (TL, CO) was unaltered in most patients [mean annual change - 2.1% (5-95 PC - 16.2 to+11.8) of predicted value]. However, there were significant decreases in the forced expiratory volume in 1 s (FEV1) before and after inhalation of 0.2 mg salbutamol [mean annual change - 0.8% (5-95 PC - 8.4 to+3.2) and - 1.3% (5-95 PC - 7.8 to+3.9) of the FVC measured, respectively]. In addition, there were significant increases in alveolar-arterial Po2 gradients (P (A a), O2) at rest and after exercise [mean annual change+1.7 mmHg (5-95 PC - 5.2 to+12.2) and+1.8 mmHg (5-95 PC - 3.5 to 9.0), respectively]. Nevertheless, the amounts were small in view of the reliability of the methods applied and reflect, at least in part, the normal process of ageing.
The annual change in FEV1/FVC was negatively correlated with FEV1/FVC at baseline (Rs=-0.46, P<0.001).
Mots-clés Pascal : Polyarthrite rhumatoïde, Homme, Toxicité, Chimiothérapie, Traitement, Poumon, Physiopathologie, Fonction respiratoire, Etude cohorte, Epidémiologie, Incidence, Pneumopathie, Facteur risque, Méthotrexate, Antirhumatismal, Immunomodulateur, Chronique, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune, Poumon pathologie, Appareil respiratoire pathologie
Mots-clés Pascal anglais : Rheumatoid arthritis, Human, Toxicity, Chemotherapy, Treatment, Lung, Pathophysiology, Lung function, Cohort study, Epidemiology, Incidence, Pneumopathy, Risk factor, Antirheumatic agent, Immunomodulator, Chronic, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease, Lung disease, Respiratory disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0286556
Code Inist : 002B02U07. Création : 199608.