{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:30:22Z","timestamp":1792024222091,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T00:00:00Z","timestamp":1764633600000},"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":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The optimal treatment strategy for rheumatoid arthritis\u2013associated interstitial lung disease (RA\u2010ILD) remains uncertain, and direct comparative data between biologics are limited. This study aimed to evaluate the effectiveness and safety of abatacept compared with rituximab in patients with RA\u2010ILD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An emulated target trial was designed using the TriNetX US Collaborative Network database, including patients with RA\u2010ILD, diagnosed between 2007 and 2024. Propensity score matching was used to balance baseline characteristics between the two treatment groups (abatacept and rituximab). The primary outcome was all\u2010cause mortality, and secondary outcomes included respiratory events, medical utilization, and infection\u2010related adverse events. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to use Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 1,615 patients per group were identified after matching for analysis. Abatacept was associated with a significantly lower risk of all\u2010cause mortality compared with rituximab (HR, 0.689; 95% CI, 0.581\u20130.818) and a reduced risk of mechanical ventilation (HR, 0.698; 95% CI, 0.521\u20130.934). The subgroup analyses yielded consistent findings. Sensitivity analyses excluding patients with concomitant connective tissue diseases also demonstrated consistent results (mortality: HR, 0.679; 95% CI, 0.570\u20130.810), reinforcing the robustness of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Abatacept was associated with a lower risk of mortality compared with rituximab in patients with RA\u2010ILD. Because clinicians may preferentially reserve abatacept for less aggressive RA\u2010ILD, residual confounding by indication cannot be excluded; thus, the association should not be interpreted as proof of causality. Prospective randomized trials are needed to confirm whether abatacept confers a true survival advantage.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/art43332-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/art.43332","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T09:18:22Z","timestamp":1753175902000},"page":"592-602","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association of Abatacept With Lower Mortality Risk Compared to Rituximab in Rheumatoid Arthritis\u2013Associated Interstitial Lung Disease: An Emulated Target Trial"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4152-9296","authenticated-orcid":false,"given":"Po\u2010Cheng","family":"Shih","sequence":"first","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine Changhua Christian Hospital  Changhua Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiow\u2010Ing","family":"Wang","sequence":"additional","affiliation":[{"name":"Center for Health Data Science, Department of Medical Research Chung Shan Medical University Hospital  Taichung Taiwan"},{"name":"Department of Health Policy and Management, College of Health Care and Management Chung Shan Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1235-0679","authenticated-orcid":false,"given":"James Cheng Chung","family":"Wei","sequence":"additional","affiliation":[{"name":"Institute of Medicine Chung Shan Medical University  Taichung Taiwan"},{"name":"Department of Allergy, Immunology and Rheumatology Chung Shan Medical University Hospital  Taichung Taiwan"},{"name":"Office of Research and Development Asia University  Taichung Taiwan"},{"name":"Graduate Institute of Integrated Medicine China Medical University  Taichung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.42861"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2023-eular.250"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2019.11.010"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa621"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2023.08.025"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13195871"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2024.152517"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2024.03.1722"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1516126"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.3027"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-020-02310-z"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5597"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-021-02655-z"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac208"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.15118"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.15055"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2017-000473"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-024-07068-2"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/key208"},{"issue":"9","key":"e_1_2_6_21_1","first-page":"501","article-title":"SER\u2010SEPAR recommendations for the management of rheumatoid arthritis\u2010related interstitial lung disease. 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