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The incidence of most extra-articular manifestations of rheumatoid arthritis (RA) has declined over time.

Identify time trends in the incidence of RA-associated interstitial lung disease (RA-ILD).

In a cohort of Olmsted County, Minnesota adult residents, we compared the incidence of RA-ILD (defined by physician diagnosis of ILD supported by consistent chest X-ray or CT findings) across 2 periods: 1955-1994 (cohort 1) vs. 1999-2014 (cohort 2). Patients were followed until death, migration, or 4/30/2019. Chi-square test, rank sum test and cox models were used for statistical analysis.

Overall, 1248 patients (71% female) were included; 603 in cohort 1, and 645 in cohort 2. At RA diagnosis, compared to cohort 1, patients in cohort 2 were younger (mean age 55.2 vs. 57.7 years; p=0.005), less likely to have ever smoked (46% vs. 53%; p=0.02), and less likely to be RF positive (59% vs. 68%; p=0.002). ILD prior to RA …