DOES THE RADIOGRAPHIC EVIDENCE OF INTERSTITIAL LUNG DISEASE INFLUENCE THE SELECTION AND SWITCHING PATTERNS OF BIOLOGIC/TARGETED SYNTHETIC DMARDs IN PATIENTS WITH RHEUMATOID ARTHRITIS? DATA FROM THE HURBIO REGISTRY
EULAR 2026, London, England, 3 - 06 June 2026, vol.85, pp.1907, (Summary Text)
- Publication Type: Conference Paper / Summary Text
- Volume: 85
- City: London
- Country: England
- Page Numbers: pp.1907
- Hacettepe University Affiliated: Yes
Abstract
Background: Interstitial lung disease (ILD) is a significant cause of morbidity and mortality in rheumatoid arthritis (RA). The impact of baseline or incident ILD findings on the choice of biologic (bDMARD) or targeted synthetic (tsDMARD) therapies remains a critical clinical question.
Objectives: This study evaluated how presence of ILD influence treatment selection and/or subsequent switching patterns in a large real-world cohort.
Methods: We analyzed 2,839 RA patients receiving b/tsDMARDs who were enrolled in the Hacettepe University Biologic (HURBIO) Registry between 2014 and 2025. Among these, patients with available chest CT scans (n=588) were identified. Presence of ILD was defined according to CT findings compatiable with ILD. Treatment patterns were evaluated in two distinct groups: 1) Patients with ILD detected prior to the initiation of their first bDMARD (pre-treatment), and 2) Patients diagnosed with ILD after the commencement of b/tsDMARD therapy (incident ILD).
Results: Among 2,839 patients, 588 had at least one chest CT. Among these 588 patients 88 had ILD. The prevalance of ILD was 3.1%. *Group 1 (Pre-treatment ILD): In 267 patients with CT scans before bDMARD initiation, 40 (14.9%) had ILD findings. In this group, the most frequently preferred initial therapies were Rituximab (n=15), followed by Anti-TNF agents (n=12), Abatacept (n=7), tocilizumab (n=3) and tofacitinib (n=3). 22 of these ILD patients had at least one control scan and 7 of them progressed. *Group 2 (Incident ILD): Among 321 patients who had CT scans after starting b/tsDMARDs, 48 (14.9%) were diagnosed with incident ILD. At the time of ILD diagnosis 17 patients were on primarily Anti-TNFs (n=17), followed by Rituximab (n=11),JAK inhibitors (n=9), abatacept
(n=6) and tocilizumab (n=4). Within 6 months of ILD detection, 20 patients (41.7%) underwent a therapy switch. Post-switch, the overall treatment distribution shifted significantly: Rituximab (n=15), Abatacept (n=10), JAK inhibitors (n=9), Anti-TNF agents (n=9) and tocilizumab (n=2).
Conclusions: The prevalence of ILD in this study was lower than previously reported in rheumatoid arthritis. Clinicians’ preference for treating ILD with immunosuppressive agents instead of b/tsDMARDs may have contributed to this result. Our findings suggest that presence of ILD influences therapeutic decision-making in RA. Rituximab was the preferred first-line choice among b/tsDMARDs in this study.