fetching data ... 
Background: Interstitial lung disease (ILD) is a common manifestation of systemic autoimmune rheumatic diseases (SARDs) and has been associated with increased morbidity and mortality in these patients. On the other hand, small airways dysfunction (SAD) is an increasingly recognized condition of patients with SARD-ILD.
Objectives: To study the effect of treatment on pulmonary function and SAD of patients with SARD-ILD.
Methods: In the current study, 47 consecutive SARD patients with ILD on HRCT were followed up prospectively and underwent pulmonary function testing at baseline visit and after 12 ± 3 months of treatment. The distribution of patients who participated in the study is presented in Table 1. All patients performed classic spirometry on both visits and were treated with rituximab only, mycophenolate mofetil (MMF) only or both. None of the patients received bronchodilators. Forced vital capacity (FVC) and forced expiratory flow after an expiration of 25% to 75% of forced vital capacity (FEF 25-75 ) were used as measures to evaluate ILD and SAD respectively. Patients with FEF 25-75 <60% predicted were defined as having SAD [1].
Results: The mean±SD age of the 47 patients was 59.8±12.0 years, while 72% were females. Twenty two patients received rituximab, 23 MMF and 2 patients both. The mean FVC before and after treatment remained stable, with no statistical significant difference (mean±SD: 2680±977ml vs. 2654±970 ml, p=0.901, %predicted: mean±SD: 85.7±25.9% vs. 86.0±24.1%, p=0.951). Twelve of 47 patients had SAD (SSc n=7, SjD n=3, RA n=1, IPAF n=1) and 6 were treated with rituximab only, 5 with MMF only and 1 patient with both. In the subgroup of SAD patients, the FEF 25-75 before and after treatment was improved both as an absolute value and as % predicted, although not statistically significant [median (range): 1315 (400-2070) ml/sec vs. 1350 (470-4110) ml/sec, p=0.863, %predicted: mean±SD: 43.4±13.8% vs. 49.0±23.4%, p=0.484]. Interestingly, 4 of 12 (34%) patients with SARD-ILD and SAD displayed FEF 25-75 >60% of predicted after treatment.
Conclusion: Treatment of SARD-ILD with rituximab or MMF seems to stabilize ILD progression and may also improve associated SAD.
REFERENCES: [1] Kampolis et al. Clin Exp Rheumatol. 2018;36 Suppl 112(3):94-101.
Distribution of patients with SARD-ILD who participated in the study.
| SARD-ILD patients (n=47) | |
|---|---|
| SSc-ILD | 22 |
| SjD-ILD | 4 |
| IIM-ILD | 4 |
| RA-ILD | 4 |
| SLE-ILD | 1 |
| MCTD-ILD | 1 |
| IPAF | 10 |
| MPA-ILD | 1 |
Abbreviations: SARD=systemic autoimmune rheumatic disease, ILD=interstitial lung disease, SSc=systemic sclerosis, IIM=idiopathic inflammatory myopathy, RA=rheumatoid arthritis, SjD= Sjögren’s disease, SLE=systemic lupus erythematosus, MCTD=mixed connective tissue disease, IPAF=interstitial pneumonia with autoimmune features, MPA=microscopic polyangiitis
Acknowledgements: NIL.
Disclosure of Interests: None declared.
© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (