ArticleThorax2025
Impact of quantitative radiological features of interstitial lung disease on immunomodulatory treatment response in three autoimmune interstitial lung disease cohorts.
Article in Thorax, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- High-resolution computed tomography assessment of connective tissue disease-associated interstitial lung disease: Advances in diagnosis and prognostic evaluation.World journal of radiology · 2026Review
- Toward precision imaging in interstitial lung disease: advances in quantitative imaging and artificial intelligence.Current opinion in pulmonary medicine · 2026Review
- Lung microenvironment proteomics identifies immune protein expression in interstitial pneumonia with autoimmune features.ERJ open research · 2026Article
- Article
- Radiological diversity in rheumatoid arthritis associated with usual interstitial pneumonia (RA-UIP) and its therapeutic implications: towards a generalizable framework of interstitial lung disease treatment.Respiratory research · 2026Review
- Upfront combination therapy with nintedanib and anti-inflammatory agents for progressive pulmonary fibrosis: a multicentre, single-arm phase 2 study (TOP-ILD).ERJ open research · 2026Article
- A House of Cards: Radiographic Foundations of Personalized Therapy in Autoimmune Interstitial Lung Disease.Annals of the American Thoracic Society · 2025Article
- Precision medicine in rheumatoid arthritis-associated interstitial lung disease: current evidence and future directions.Current opinion in pulmonary medicine · 2025Review
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Authors and funding
10 authors.
Funding
Abstract
backgroundThe defining radiological features of autoimmune interstitial lung disease (ILD) are ground glass opacification (GGO) and fibrosis. The associations between these features and physiological response to immunomodulation remain unclear.
methodsThis study leveraged three autoimmune ILD cohorts: two with systemic sclerosis (SSc) and one with rheumatoid arthritis (RA) which were selected for inherent differences in fibrotic extents/patterns. Linear regression models examined associations between baseline quantitative GGO, fibrosis, their ratio and forced vital capacity (FVC)%-predicted changes after 12 months of immunomodulatory therapy.
resultsPatients with SSc-ILD (N=262) exhibited a higher GGO-to-fibrosis ratio compared with patients with RA-ILD (N=130) (mean ratio 3.0 vs 0.25). Increased GGO-to-fibrosis was not associated with improved FVC%-predicted in any cohort. Conversely, in patients with SSc-ILD treated with cyclophosphamide (CYC), increased fibrosis (estimate 0.17 (95% CI 0.003, 0.33); p=0.04) and increased GGO (estimate 0.15 (95% CI 0.004, 0.30); p=0.044) were both significantly associated with FVC% improvement. Given the negative direction of the estimate for GGO-to-fibrosis ratio (estimate -0.33 (95% CI -0.61, -0.06); p=0.016), CYC was associated with greater FVC% improvement in patients with a higher degree of fibrosis relative to GGO. No significant correlation was seen in patients with SSc-ILD treated with mycophenolate (N=56) or in patients with RA-ILD treated with immunomodulation (N=130). DISCUSSION: Increased quantitative GGO relative to fibrosis was not significantly associated with improved response to immunomodulation in patients with RA-ILD and SSc-ILD. However, increased quantitative fibrosis and GGO extent were associated with improved response to CYC in SSc-ILD. More research is needed to understand how to use radiological features to guide treatment selection in ILD.
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