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The global prevalence of interstitial lung disease in patients with rheumatoid arthritis: a systematic review and meta-analysis

Hari Prasanna, C. Inderjeeth, J. Nossent, K. Almutairi

Rheumatology International, 2025

14,281 participants · 15 citations

Abstract

This study aims to review the literature and estimate the global pooled prevalence of interstitial lung disease among patients with rheumatoid arthritis (RA-ILD). The influence of risk factors like geography, socioeconomic status, smoking and DMARD use will be explored. A systematic review was performed according to the PRISMA and JBI guidelines. Studies published between January 1980 and February 2024 were sourced from 7 electronic databases and screened for eligibility. A random-effects meta-analysis model was used to produce pooled prevalences and the potential between-study heterogeneity was identified using sensitivity, subgroup, meta-regression and correlation analyses. 33 studies were included in this meta-analysis containing 14,281 RA patients. The global pooled prevalence of RA-ILD was 21.38% (CI: 0.1542–0.2886), with a high heterogeneity (I2) of 98%. The prevalence of usual interstitial pneumonia and non-specific interstitial pneumonia among RA patients were 11.01% and 6.86% respectively. Africa had the highest RA-ILD prevalence with an imprecise estimate of 38.15% (95% Confidence Interval [CI]: 2.29–94.2) and Europe had the lowest prevalence of 10.15% (CI: 2.86–30.23). Other risk factors associated with a higher prevalence of RA-ILD included living in low-income countries, smoking and DMARD use. The biggest limitation of this study is the high heterogeneity of results and underrepresentation of Oceania and low-income countries. This study has clarified the global…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 14,281 participants or records.

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