ILD

When you don’t use anti-fibrotics in RA-ILD RA-ILD occurs in somewhere up to 10% of patients with RA. It is a serious complication with significant morbidity and mortality attached to it. https://t.co/K6tEtjf9Gm https://t.co/Hehv0HbD7y

When you don’t use anti-fibrotics in RA-ILD | RheumNow

Article

Scary IPAF

Daric A. Mueller, PA-C Nov 09, 2026

Interstitial pneumonia with autoimmune features (IPAF) describes patients who have interstitial lung disease (ILD) plus clinical, serologic, or morphologic features of autoimmunity but who do not meet criteria for a defined connective tissue disease. The 2015 ERS/ATS criteria

Respiratory infections: a potential missing link in RA-ILD development #ACR26 Abstract 1737: Respiratory infections were associated with subsequent RA-ILD, particularly non-fibrotic disease. A new perspective on infection prevention in RA. @RheumNow https://t.co/ObzgmwguV0

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Not all ILD is created equal #ACR26 Abstract 1375: RA-ILD showed a fibrotic, UIP-predominant phenotype (64% vs 37% in Sjögren), while Sjögren-ILD was more inflammatory. Different phenotypes, different monitoring strategies, even with similar FVC trajectories. @RheumNow #ACR26 https://t.co/yWnnX1Y6Wv

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Never too late for nerandomilast? Patients with auto-immune ILD PPF enrolled in FIBRONEER-ILD trial experienced slowing of ILD regardless of time since ILD Dx even >5 yrs. Abstract #1617 #ACR26 @RheumNow https://t.co/ylyKDrd1Xe

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DM-ILD pts enrolled in Ph3 brepocitinib (VALOR) trial encompassed 20% of study population. Subgroup analysis sees improvements in TIS and steroid sparing effect regardless of ILD status. Abstract 1586, #ACR26 @RheumNow https://t.co/oKebDrAE9E

https://x.com/rheumPAC/status/2119851880583221307/photo/1

Abstract #1619 Retrospective look at mortality and healthcare utilization trends in interstitial pneumonia with autoimmune features (IPAF): Within 5 years of IPAF incidence: 42% died 69% hospitalized 89% w/ ED visit 14% newly Rx'd O2 #ACRbest #ACR26 @RheumNow

McDermott et al. 4000 patients. Respiratory infections associated subsequent RA-ILD. @RheumNow #ACR26 Abstr#1737 https://t.co/fWpNWveIbI

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Kim et al. Korean single-centre study 664 patients. RA-ILD associated with 7-fold increase in risk of lung cancer compared to RA alone. @RheumNow #ACR26 Abstr#1888 https://t.co/Y8XFDgANi5

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Ibis et al. GLP-1 agonists in RA associated lower risk of pulmonary hypertension, resp failure, mech ventilation, all-cause mortality (but not ILD). @RheumNow #ACR26 Abstr#1445 https://t.co/0E8qCFJTup

https://x.com/RichardPAConway/status/2119831883328422144/photo/1

SjD diagnosis: -No test w/ absolute specificity -Sicca does not need to be present for a dx. -Extraglandular manifestations also play role in dx: ILD, purpura, hypergammaglobulinemia, low complements etc -Symtom burden not always correlate with DAI -Sicca can be absent in certain https://t.co/8HG69extNv

Article

Eosinophilia and RA-ILD

Daric A. Mueller, PA-C Nov 09, 2026

The absolute eosinophil count (AEC) on a routine complete blood count could be a useful addition when deciding which patients to work up for RA-ILD.

Who will progress in #SSc-ILD? +Scl70 Male African American #smoker Worsening #mRSS #aspiration CRP, KL6? 60 SSc-ILD v 19 SSc no ILD FVC%pred related to baseline #KL6 & #ICAM-1 But NOT predicted worsening But small study Better markers needed #ACR26 0037 @RheumNow @ACRheum https://t.co/mvpL17Mdjr

https://x.com/Janetbirdope/status/2119599824886444120/photo/1

Impt pathway for #fibrosis & #inflammation? FIbrosis in #sarcoidosis mediated thru #TL1A Myeloid cells —granulomas TL1A effects TNF IL1beta IL6 IL17 Drugs could be effective Some already in #IBD Ex #Tulisokibart #Duvakitug #Afimkibart 🤷 #O019 #ACR26 @RheumNow @ACRheum https://t.co/GPKwEqWFkh

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Short #telomeres are associated w #IPF Cool study from #UCSF @ACRheum #ACR26 showed #senescence In #PPF & #SARD-ILD -epithelial remodeling w #DNA damage Same theme leading to ILD—#fibrosis ?Rx pathway for repair #0025 @RheumNow https://t.co/8wjtYgBXNF

https://x.com/Janetbirdope/status/2119593217159053543/photo/1

I used to think #SSc #scleroderma pts w #SjD #Sjogren’s did better as more Mild ‘#CREST’ Nope 👎 #CSRG study N>1000 pts showed #SjD had =#mRSS But ⬆️#GI #gut issues ⬆️ #ILD ? From +#Ro ⬇️worse #QoL #0231 #ACR26 @ACRheum @RheumNow https://t.co/A4zxpc24XN

https://x.com/Janetbirdope/status/2119589521796809193/photo/1

#dcSSc active Early allogenic #CAR-T -initial dosing had #mRSS drop of 16pts (L Chung) Well tolerated in vivo #CAR-T #CD19 N=3 SSc + for #skin & #lung 🫁 from China + in SLE NEJM just published closer to scalable Rx vs autologous! #ACR26 @RheumNow @ACRheum #0223, 0225

Mortality in IIM-ILD: frontloaded but survival + improvement possible! 2 year mortality outcomes in a newly diagnosed IIM-cohort (n=41), 15% died @ median time of 8.5 months. Of survivors, only 13.3% progressed, 46.7% improved as measured by % pred FVC. #ACR26 @Rheumnow

#ACR26 @RheumNow Ab#0478 Baricitinib in 84 RA-ILD pts Improved/stable dyspnea 83%, HRCT 68% at mean f/u 48 mos. DAS28-ESR from 4.3 to 2.8, median pred from 5 mg/d to 0 https://t.co/HTjUY7mHkV

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#ACR26 @RheumNow Ab#0475 - AutoAb in ILD 48 pts analyzed Anti-Sa Ab in 15%, Anti-CarP 25% ILD in 8% pts, erosive RA in 15% Sa - higher prev of ILD (43 v 2%), higher erosion but not signif CarP not assoc w ILD, erosive disease (though previous associations have been reported)

#ACR26 @RheumNow Ab#0495 Leflunomide Duration and Dose - NOT associated with incident/progressive ILD Longitudinal study of 184 RA patients LEF associated with 4% lower risk of radiologic worsening, each gram of cumulative dose with 6.4% lower risk https://t.co/VeREpEQ5wc

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#ACR26 @RheumNow Ab#0448 Addition of Nintedanib to Abatacept in RA-ILD 80 pts progressive ILD, 263 non-progressive. NNTE added to 6 prog, 13 non-prog Non-prog- no signif results In prog RA-ILD, ABA+NINTE showed stabilized FVC on f/u over 48 mo https://t.co/MPpzqT4ajr

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#ACR26 @RheumNow Ab#0244 Prospective study 106 pts - SSc <5 yr duration from 1st nonRP sx Screening w HRCT, PFTs, auscultation 24% clinical ILD, 19% screening-detected ILD, 58% no ILD 33% pts w/o crackles had ILD on screening Screen-detected ILD had higher serum MMP-7 to no ILD

Jessen et al. Infection and ILD progression leading causes of death in RA-ILD. ILD was directly or indirectly involved in 2/3 of deaths. ILD-related deaths predominate with impaired FVC, infectious and CV deaths in those with preserved lung function @RheumNow #ACR26 Abstr#0503 https://t.co/VGdO7SsrJx

https://x.com/RichardPAConway/status/2119488621472559303/photo/1

#ACR26 @RheumNow Ab#0221 Nintedanib in SSc-ILD, advanced progressing pts 36 pts, non-smokers, 39% dcSSc. Most background immunosuppr Relative FVC decline >5% in 69%, >10% in 39% AEs: 50% diarrhea, dose reduction in 64%, but permanent discontin in only 2 pts (6%) 33% escal to RTX https://t.co/kQnsPrbECB

https://x.com/ericdeinmd/status/2119487184449556574/photo/1

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