Rheumatoid arthritis (RA) is a systemic inflammatory disorder, with the most common extra-articular manifestation of RA being lung involvement. While essentially any of the lung compartments can be affected and manifest as interstitial lung disease (ILD), pleural effusion, cricoarytenoiditis, constrictive or follicular bronchiolitis, bronchiectasis, pulmonary vasculitis, and pulmonary hypertension, RA-ILD is a leading cause of death in patients with RA and is associated with significant morbidity and mortality. In this review, we focus on the common pulmonary manifestations of RA, RA-ILD and airway disease, and discuss evolving concepts in the pathogenesis of RA-associated pulmonary fibrosis, as well as therapeutic strategies, and have revised our previous review on the topic. A rational clinical approach for the diagnosis and management of RA-ILD, as well as an approach to patients with clinical worsening in the setting of treatment with disease-modifying agents, is included. Future directions for research and areas of unmet need in the realm of RA-associated lung disease are raised.

类风湿性关节炎 (RA) 是一种全身性炎症性疾病，RA 最常见的关节外表现是肺部受累。虽然基本上任何肺室都可能受到影响并表现为间质性肺病 (ILD)、胸腔积液、环杓炎、缩窄性或滤泡性细支气管炎、支气管扩张、肺血管炎和肺动脉高压，但 RA-ILD 是患者死亡的主要原因与 RA 相关，并与显着的发病率和死亡率相关。在这篇综述中，我们关注 RA、RA-ILD 和气道疾病的常见肺部表现，并讨论 RA 相关肺纤维化发病机制的演变概念以及治疗策略，并修订了我们之前关于该主题的综述. RA-ILD 诊断和管理的合理临床方法，以及在使用疾病调节剂治疗的情况下临床恶化患者的方法。提出了 RA 相关肺病领域的未来研究方向和未满足需求的领域。