{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:39:17Z","timestamp":1792665557872,"version":"4.5.0"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We evaluated real\u2010world treatment patterns in rheumatoid arthritis\u2013associated interstitial lung disease (RA\u2010ILD) within the Veterans Health Administration (VA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a cohort study of RA\u2010ILD treatment patterns in the VA between 2006 and 2021. Patients with RA\u2010ILD were identified using validated administrative algorithms. Pharmacy databases were queried for medication dispensing before and after ILD diagnosis. The primary comparison was the proportion of patients prescribed each medication before and after ILD diagnosis. Multivariable Cox regression was used to evaluate predictors of initiating an American College of Rheumatology (ACR)\/American College of Chest Physicians (CHEST) guideline recommended medication after ILD diagnosis among patients not using these therapies at baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4,108 patients with RA\u2010ILD, mean age was 68.6 years and 93.4% were male. Prednisone was commonly prescribed before (64.6%) and after (76.7%) ILD diagnosis. Use of conditionally recommended first\u2010line therapies in the ACR\/CHEST guideline (mycophenolate, azathioprine, rituximab, and cyclophosphamide) increased after ILD diagnosis, but the overall frequency was low (range 1.2% to 12.0%). Methotrexate use decreased (47.1% to 30.4%), whereas leflunomide, tumor necrosis factor inhibitors, and abatacept use increased after ILD diagnosis. Reduced forced vital capacity, anti\u2013cyclic citrullinated peptide\/rheumatoid factor seropositivity, ILD diagnosis between 2012 and 2021 (vs 2006 and 2011), and higher pulmonary visit frequency were associated with guideline recommended medication initiation while older age at RA\u2010ILD diagnosis, and higher comorbidity burden were associated with less frequent initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Most ACR\/CHEST first\u2010line recommended therapies for RA\u2010ILD treatment were infrequently used among VA patients with RA\u2010ILD between 2006 and 2021. These findings illustrate real\u2010world use of RA\u2010ILD therapies and suggest that treatment decisions in RA\u2010ILD are guided by many factors in addition to ILD severity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.90135","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:49:46Z","timestamp":1787100586000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Treatment Patterns in Rheumatoid Arthritis\u2013Associated Interstitial Lung Disease"],"prefix":"10.1002","volume":"8","author":[{"given":"Justin T.","family":"Dunn","sequence":"first","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott M.","family":"Matson","sequence":"additional","affiliation":[{"name":"University of Kansas Medical Center  Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0398-2308","authenticated-orcid":false,"given":"Michael D.","family":"George","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VA Medical Center and University of Pennsylvania  Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangyuna","family":"Yang","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Punyasha","family":"Roul","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean D'Amour","family":"Kwizerimana","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Rojas","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System  Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6640-9173","authenticated-orcid":false,"given":"Grant W.","family":"Cannon","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System and University of Utah  Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3546-3051","authenticated-orcid":false,"given":"Brian","family":"Sauer","sequence":"additional","affiliation":[{"name":"VA Salt Lake City Health Care System and University of Utah  Salt Lake City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8907-8976","authenticated-orcid":false,"given":"Jeffrey R.","family":"Curtis","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua F.","family":"Baker","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz VA Medical Center and University of Pennsylvania  Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0897-2272","authenticated-orcid":false,"given":"Ted R.","family":"Mikuls","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-3588","authenticated-orcid":false,"given":"Bryant R.","family":"England","sequence":"additional","affiliation":[{"name":"VA Nebraska\u2010Western Iowa Health Care System and University of Nebraska Medical Center  Omaha"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-022-00827-y"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27405"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25053"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(22)00260-0"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.11.035"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.09.005"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(24)00265-0"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-028466"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42861"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24043"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-218282"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5744"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41752"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-024-07068-2"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-22-1820"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kead027"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-024-07028-w"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25620"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.21806"}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.90135","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acr2.90135","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.90135","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T09:56:24Z","timestamp":1792662984000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.90135"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":19,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/acr2.90135"],"URL":"https:\/\/doi.org\/10.1002\/acr2.90135","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"value":"2578-5745","type":"print"},{"value":"2578-5745","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-04-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e90135"}}