ANCHOR-RA: Multi-National Cross-Sectional Study on ILD Screening in Rheumatoid Arthritis Patients

At December 17, 2024

Design of ANCHOR-RA: a multi-national cross-sectional study on screening for interstitial lung disease in patients with rheumatoid arthritis

BMC Rheumatol. 2024 May 21;8(1):19. doi: 10.1186/s41927-024-00389-4.

Jeffrey A Sparks 1, Philippe Dieudé 2, Anna-Maria Hoffmann-Vold 3 4, Gerd R Burmester 5, Simon Lf Walsh 6, Michael Kreuter 7, Christian Stock 8, Steven Sambevski 9, Margarida Alves 9, Paul Emery 10

Affiliations

• 1 Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Harvard Medical School, 60 Fenwood Road, #6016U, Boston, MA, 02115, USA. jsparks@bwh.harvard.edu.
• 2 Department of Rheumatology, Bichat-Claude Bernard University Hospital, Assistance Publique-Hôpitaux de Paris, INSERM UMR1152, University of Paris, Paris, France.
• 3 Department of Rheumatology, Oslo University Hospital, University of Zurich, Oslo, Norway.
• 4 Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
• 5 Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
• 6 National Heart and Lung Institute, Imperial College London, London, UK.
• 7 Center for Pulmonary Medicine, Departments of Pneumology, Critical Care & Sleep Medicine, Mainz University Medical Center and of Pulmonary, Marienhaus Clinic Mainz, Mainz, Germany.
• 8 Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim am Rhein, Germany.
• 9 Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany.
• 10 NIHR Leeds Biomedical Research Centre, Institute of Rheumatic and Musculoskeletal Medicine, Leeds Teaching Hospitals NHS Trust and Leeds, University of Leeds, Leeds, UK.
Abstract

Background: Patients with rheumatoid arthritis (RA) are at risk of developing interstitial lung disease (ILD), which is associated with high mortality. Screening tools based on risk factors are needed to decide which patients with RA should be screened for ILD using high-resolution computed tomography (HRCT). The ANCHOR-RA study is a multi-national cross-sectional study that will develop a multivariable model for prediction of RA-ILD, which can be used to inform screening for RA-ILD in clinical practice.

Methods: Investigators will enrol consecutive patients with RA who have ≥ 2 of the following risk factors for RA-ILD: male; current or previous smoker; age ≥ 60 years at RA diagnosis; high-positive rheumatoid factor and/or anti-cyclic citrullinated peptide (titre > 3 x upper limit of normal); presence or history of certain extra-articular manifestations of RA (vasculitis, Felty's syndrome, secondary Sjögren's syndrome, cutaneous rheumatoid nodules, serositis, and/or scleritis/uveitis); high RA disease activity in the prior 12 months. Patients previously identified as having ILD, or who have had a CT scan in the prior 2 years, will not be eligible. Participants will undergo an HRCT scan at their local site, which will be assessed centrally by two expert radiologists. Data will be collected prospectively on demographic and RA-related characteristics, patient-reported outcomes, comorbidities and pulmonary function. The primary outcomes will be the development of a probability score for RA-ILD, based on a multivariable model incorporating potential risk factors commonly assessed in clinical practice, and an estimate of the prevalence of RA-ILD in the study population. It is planned that 1200 participants will be enrolled at approximately 30 sites in the USA, UK, Germany, France, Italy, Spain.

Discussion: Data from the ANCHOR-RA study will add to the body of evidence to support recommendations for screening for RA-ILD to improve detection of this important complication of RA and enable early intervention.
Trial registration: clinicaltrials.gov NCT05855109 (submission date: 3 May 2023).

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