LAUSR

Background: Pulmonary involvement is one of the main extraarticular manifestations of rheumatoid arthritis (RA) and can be influenced by the different therapies used to treat RA. In order to detect any pulmonary changes and rapidly institute appropriate care when necessary, the participation of the patient is essential. Patients must report any respiratory symptoms to their doctor who can then adapt the clinical examination and determine the need for additional investigations. Objectives: Evaluate patients’ knowledge about the pulmonary manifestations of RA, their follow-up and their needs in terms of information. Methods: A 20 item questionnaire was developed by a group of patients and posted online using Survey Monkey software with a link sent to 6,702 members of the Association Française des Polyarthritiques. Anonymous responses were collected between November 8–23, 2017. Results: 1,318 patients answered the questionnaire (19.7% response rate). Among the 1,297 patients with rheumatoid arthritis (RA): 1,110 were women (86.1%), the mean age was 60.3 years [16–86], 54% (701/1,284) were diagnosed with RA more than 10 years earlier, 76.4% (927/1,213) were on pharmaceutical maintenance treatment and 44.11% (535/1,213) on biologic therapy, and 56% (679/1,213) had received pneumococcal vaccination. 45.5% (552/1212) of respondents did not know that RA could affect the lungs. Among the others, two-thirds (417/659) had been informed of this by their rheumatologist. 39.8% (481/1,209) reported possible respiratory symptoms or dry cough. Among them, 69.1% (188/272) of those who knew that RA could affect the lungs had discussed their symptoms with their rheumatologist, 62.9% (171/272) were referred to a pulmonologist and 83.2% (188/272) were prescribed specific tests (x-ray, CT scan, etc.). Among respondents who did not know that RA could affect the lungs, only 32.8% (67/204) discussed their symptoms with their rheumatologist, 32.4% (66/204) were referred to a pulmonologist and 52.7% (107/207) underwent further tests. In 44.6% (149/334) of cases, the specific tests revealed lung changes. 86.5% (1016/1,174) of respondents expressed the need to be better informed about the lung manifestations of RA and 60.4% (709/1,174) felt that they did not receive a thorough evaluation of their pulmonary status. Those who were referred to a pulmonologist gave an average score of 5.38/10 for the coordination between rheumatologist and pulmonologist. Among the solutions proposed, the respondents would find it very appropriate (8 to 10/10): 76.2% (895/1,174) to be informed if they are among those at risk; 74% (869/1,174) to be alerted to symptoms that should prompt them to react; 60% (707/1,174) to benefit from regular monitoring of their respiratory status by the rheumatologist. On the other hand, regular consultation with the pulmonologist was considered very appropriate by only 48% (563/1,174). Conclusions: The rate of participation in this survey illustrates patients’ interest and need for information on this subject. The high percentage of patients (45.5%) who had not been informed about the risks of RA-related pulmonary involvement proves that there is room for improvement in patient education so that patients can be able and aware of how to detect any symptoms that need to be brought to the attention of their rheumatologist. Acknowledgements: With the support of Boehringer Ingelheim. Disclosure of Interest: C. Beller: None declared, P. Preiss: None declared, Y. Allanore Grant/research support from: Roche, Pfizer, BMS, Sanofi, UCB, Consultant for: Actellion, Bayer, ChemomAb, Genentech/Roche, Inventiva, Pfizer, Boehringer, Servier, MEDAC