Background: Rheumatic diseases include a heterogeneous group of systemic autoimmune diseases that can sometimes pose diagnostic and therapeutic challenges. For this reason, it is essential for hospitals to have a multidisciplinary committee that includes various specialists such as pulmonologists or nephrologists, to facilitate decision-making and the management of complex patients.

Objectives: To evaluate the activity of a multidisciplinary committee and its utility in the diagnostic assessment and management of patients with Systemic autoimmune rheumatic diseases (SARDs) in a tertiary care university hospital.

Methods: This retrospective observational study was conducted in the Department of Rheumatology of a tertiary care university hospital in Southern Spain. It includes all patients who were evaluated by a multidisciplinary committee on systemic autoimmune rheumatic diseases between March 2023 and July 2024. The members of the committee included specialists in rheumatology, pulmonology, nephrology, internal medicine, radiology, dermatology, immunology, neurology, gastroenterology and hematology. The electronic medical records of all patients were analyzed. Sociodemographic, clinical and underlying disease variables were collected, as well as the main decisions of the committee in the diagnosis and treatment of patients. Finally, a descriptive analysis was performed.

Results: A total of 94 patients were included, with 64.89 % being female. 17.02% of the patients were smokers and 27.66% ex-smokers. 31 of them (32,97%) were presented to previous committees. The mean age was 58.63 years ± 16.39 [55.25-62.01], with an average disease duration of 6.23 years ± 8,17 [4.43-8.03). 13 (13,97%) were diagnosed with Rheumatoid Arthritis, 13 (13.97%) with systemic lupus erythematosus (LES), 12 (12.9%) with myopathy, 11 (11.83%) with vasculitis, 10 (10.75%) with scleroderma (Scl), 9 (9.68%) with Sjögren syndrome (SS), 6 (6,45%) with sarcoidosis, with the other conditions being less frequently encountered. The prevalence of ILD was 46.24%. Prior to presentation to the committee, 46.81% of patients were receiving conventional synthetic DMARDs, followed by 29.79% who were receiving immunosuppressants such as mycophenolate or azathioprine, and 28.73% with biological DMARDs. However, the majority (31.91%) had not received any treatment prior to the committee. Corticosteroids were used by 76.59% (n=72). After the committee, the majority of patients (38.01%) are being treated with immunosuppressants, followed by 34.77% receiving biological therapy and 24.96% with conventional synthetic DMARDs. However, 18.48% are not receiving any treatment. In addition, rates of glucocorticoid use were lower after specialist decision (48.31% vs 76.59%), predominantly low-dose corticosteroids (defined as ≤ 10 mg/d of prednisone or equivalent). The affected organ that motivated the need for evaluation in the committee was a lung in 46.14% (n=42), followed by kidney 25.26% (n=23), and muscle in 8.78% (n=8), with the remaining organs being less common. It was decided to expand the diagnostic study in 27.96% of cases, requiring biopsy in 15 (57.69%) of them, with renal biopsy being the most frequent in 33.33%. The request for imaging tests was agreed upon in 4 (15.38%) cases, and laboratory tests in 2 (7.69%). In 61.7%, it was decided to start treatment, with the most common being bDMARDs in 22 cases (37.93%), followed by immunosuppressants in 15 (25.86%). Additionally, it was decided to increase or initiate corticosteroid therapy in 9 (9.68%), adopt a watchful waiting approach in 11 (11.82)%, as well as withdraw treatment in 13 (13.98%).

Conclusion: A multidisciplinary team enables a comprehensive approach, as well as greater diagnostic precision and patient safety. The main decisions taken by the committee were the initiation of treatments with specific targets (especially bDMARDs) and the request for diagnostic tests, notably including the need for tissue biopsy and imaging studies. These data demonstrate the importance of committees for the evaluation of patients with SARDs. Therefore, the implementation of multidisciplinary committees in centers that manage these complex patients should be considered, thus facilitating diagnostic and therapeutic decision-making.

REFERENCES: NIL.

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 ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.