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To develop a joint proposal for screening criteria of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA) and vice versa, which serves as a guidelines in patient referral between the Rheumatology and Pneumology departments to early detection of these patients.A systematic literature review was carried out on the risk factors for the development of ILD in RA patients, and for the referral criteria to Rheumatology for suspected early RA. Based on the available evidence, screening criteria were agreed using the Delphi method by a panel of pneumologists and rheumatologists with expertise in these pathologies.Screening criteria for ILD in patients with RA and for the early detection of RA in cases with ILD of unknown etiology have been developed. In both cases, a detection strategy was based on clinical risk factors. Recommendations also included the complementary tests to be carried out in the different clinical scenarios and on the periodicity that screening should be repeated.A selective screening strategy is recommended for the first time in the early diagnosis of patients with ILD-RA. This multidisciplinary proposal aims to solve some common clinical questions and help decision-making, although its usefulness to identify these patients with good sensitivity must be confirmed in a validation study.

Introduction: Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the prognosis. Methods: A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD between 2013 and 2018. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. Results: 106 patients were included. The mean age was 70.2±19.8 years and 51.9% of the patients presented UIP pattern. In the multivariate Cox analysis the age (HR 1.33, 95% CI 1.09-1.62, p=0.0045), the DLCO (%) (HR 0.85, 95% CI 0.73-0.98, p=0.0246), and the final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39-0.99, p=0.0465) were independent predictor variables of mortality, as well as the GAP index (HR 4.65, 95% CI 1.59 - 13.54, p=0.0051) and the CPI index (HR 1.12, 95% CI 1.03 - 1.22, p=0.0092). Also highlight that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01-1.23, p = 0.035). Conclusions: This is the first study where it is objectified that the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.