Sparks JA, et al. - A sum of 1419 participants with mean age 55.8 years were examined to quantify rheumatoid arthritis (RA) disease activity and risk for RA-associated interstitial lung disease (RA-ILD) using the Brigham RA Sequential Study (BRASS, 2003-2016). They noted that 68.6% of candidates were seropositive. During mean 8.9 years (SD 4.2) of follow-up/subject, 85 incident RA-ILD cases were identified. They reported an increased risk for RA-ILD across disease activity categories: 1.00 (reference) for remission, 1.41 (0.61-3.28) for low, 2.08 (1.06-4.05) for moderate, and 3.48 (1.64-7.38) for high. They found RA-ILD risk increased by 35% for every unit increase in Disease activity scores using 28 joints (DAS28). An association between active RA and increased risk of developing RA-ILD was noted suggesting an alteration in the natural history of RA-ILD development with a decline in systemic inflammation.