RA and its affect on the lungs

My mother has a chronic lung condition that has been diagnosed as RA.  She has damage to the lungs, confirmed on scans and bronchoscopy.  She was initially diagnosed as suffering from idiopathic pulmonary fibrosis.  This diagnosis was excluded because, basically, she has lived too long and the disease did not progress as IPF would be expected to.  Biopsy of the lung was deferred because she was told that there would be no definitive treatment regardless of what pathology showed.  She is oxygen dependent (3L), has been on long term predinisone and methatrexate therapy.  Her joints are relatively unaffected.  The methatrexate was recently discontinued and the prednisone is slowly being reduced.  She has not improved but has gotten slowly worse.  Assuming the diagnosis is correct, are there any new therapies which may be available to assist her.  While her doctors are caring, I am afraid she is now falling into the "You've lived a good, long life" category (she is 80 years old).  Would pulmonary therapy be beneficial -- her blood pressure and heart function are wonderful.  This woman never smoked a day in her life and she lives as if she is in end stage emphysema.  Any suggestions would be greatly appreciated.

Brian

[Kevin Pho, MD]

The effects of rheumatoid arthritis on the lungs are incompletely understood.  Research suggests that there is an increased risk of infection due to a subclinical inflammatory lung disease.  

The treatment would depend on what exactly was found on the biopsy.  In many cases, if there is inflammation present, the medications that would treat the rheumatoid arthritis would also treat the lung symptoms.  

For further options, you can consider another pulmonary opinion - preferably one at a major academic medical center.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[Belledonna]

Hi
  I have RA and have had the diagnosis for about 3 years.
Can she take Enbrel? It might help with relieving the symptoms of inflammation.
   I currently take Enbrel and methotrexate as well as Naproxen (the lattrer is for OA).
    Also, there is a new med just approved by the FDA which my arthritis group is looking into and it is  Retuximab.I believe it has good success wth RA.