Patients with late-onset rheumatoid arthritis and chronic lung disease achieved broadly similar long-term disease control with a treat-to-target strategy compared with those without lung disease, but they experienced more serious adverse events and were less likely to maintain treatment adherence because of comorbidities and treatment complications. In the 5-year prospective CRANE cohort study, remission rates at year 5 were 30% in patients with chronic lung disease vs 44% in those without, while serious infections, interstitial lung disease worsening, and fractures occurred more frequently in the chronic lung disease group.