{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:49:26Z","timestamp":1775580566490,"version":"3.50.1"},"reference-count":29,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"unspecified","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001003","name":"Boehringer Ingelheim","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100001003","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,25]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Patients with systemic autoimmune rheumatic disease (SARD) are at high risk of developing interstitial lung disease (ILD). We sought to gain insight into the pharmacological and non-pharmacological treatments being used by patients with SARD-associated ILD (SARD-ILD) following ILD progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a retrospective, observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Optum Clinformatics Data Mart administrative medical and pharmacy claims database in the USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients with SARD-ILD who had an incident ILD diagnosis and progression between January 2018 and March 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Treatment patterns and healthcare services utiliation were descriptively summarised for baseline and follow-up periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 6431 patients with SARD-ILD and evidence of ILD progression (mean age, 71.2 years; 75.3% female; 68.9% white). The mean (SD) time between the initial SARD-ILD diagnosis and the onset of ILD progression (index date) was 104 (201) days. On average, patients were followed for 936 (467) days.<\/jats:p>\n                    <jats:p>Oral corticosteroids were the most common treatment post-progression (69.5%), followed by non-biologic disease-modifying antirheumatic drugs (non-biologic DMARDs) (41.6%), biologic DMARDs (15.5%) and immunomodulators (15.4%). Antifibrotics were received by 3.5% of patients. Supplemental oxygen was the most frequent non-pharmacological treatment (48.9%). For the baseline period, 53.0% and 42.1% of patients used inpatient and emergency department services, respectively. During the follow-up, 69.7% and 62.8%, respectively, used these services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The high use of corticosteroids and limited use of DMARDs and antifibrotics post-progression in this descriptive study implies a significant gap between current practice and optimal management of patients with SARD-ILD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-114632","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T15:50:25Z","timestamp":1775577025000},"page":"e114632","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Post-progression treatment patterns in systemic autoimmune rheumatic disease-associated interstitial lung disease: insights from a US retrospective, observational study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1874-8880","authenticated-orcid":false,"given":"Joseph","family":"Yang","sequence":"first","affiliation":[{"name":"Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katy","family":"Sadowski","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akshay","family":"Kharat","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann","family":"Chauffe","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tejaswini","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"2026040708501390000_16.4.e114632.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01052-2"},{"key":"2026040708501390000_16.4.e114632.2","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/MCP.0000000000000791","article-title":"The other connective tissue disease-associated interstitial lung diseases: Sjogren\u2019s syndrome, mixed connective tissue disease, and systemic lupus erythematosus","volume":"27","author":"Lee","year":"2021","journal-title":"Curr Opin Pulm Med"},{"key":"2026040708501390000_16.4.e114632.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2022-001291","article-title":"Incidence and prevalence of interstitial lung diseases worldwide: a systematic literature review","volume":"10","author":"Shah Gupta","year":"2023","journal-title":"BMJ Open Resp Res"},{"key":"2026040708501390000_16.4.e114632.4","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1002\/acr.25348","article-title":"2023 American College of Rheumatology (ACR)\/American College of Chest Physicians (CHEST) Guideline for the Treatment of Interstitial Lung Disease in People with Systemic Autoimmune Rheumatic Diseases","volume":"76","author":"Johnson","year":"2024","journal-title":"Arthritis Care & Research"},{"key":"2026040708501390000_16.4.e114632.5","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.114264"},{"key":"2026040708501390000_16.4.e114632.6","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/S2213-2600(19)30480-1","article-title":"Systemic sclerosis-associated interstitial lung disease","volume":"8","author":"Perelas","year":"2020","journal-title":"Lancet Respir Med"},{"key":"2026040708501390000_16.4.e114632.7","doi-asserted-by":"crossref","first-page":"105133","DOI":"10.1016\/j.jbspin.2021.105133","article-title":"Predictors of mortality in rheumatoid arthritis-associated lung disease: A retrospective study on ten years","volume":"88","author":"Ekici","year":"2021","journal-title":"Joint Bone Spine"},{"key":"2026040708501390000_16.4.e114632.8","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.171315"},{"key":"2026040708501390000_16.4.e114632.9","doi-asserted-by":"crossref","first-page":"152164","DOI":"10.1016\/j.semarthrit.2023.152164","article-title":"Intravenous cyclophosphamide improves functional outcomes in interstitial lung disease related to idiopathic inflammatory myopathies","volume":"59","author":"Moreno-Torres","year":"2023","journal-title":"Semin Arthritis Rheum"},{"key":"2026040708501390000_16.4.e114632.10","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab931"},{"key":"2026040708501390000_16.4.e114632.11","doi-asserted-by":"crossref","unstructured":"Mena-V\u00e1zquez N , Rojas-Gimenez M , Romero-Barco CM , et al . n.d. Characteristics and Predictors of Progression Interstitial Lung Disease in Rheumatoid Arthritis Compared with Other Autoimmune Disease: A Retrospective Cohort Study. Diagnostics (Basel) 11:1794. doi:10.3390\/diagnostics11101794","DOI":"10.3390\/diagnostics11101794"},{"key":"2026040708501390000_16.4.e114632.12","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1093\/rheumatology\/kex072","article-title":"Effect of rituximab on the progression of rheumatoid arthritis-related interstitial lung disease: 10 years\u2019 experience at a single centre","volume":"56","author":"Md Yusof","year":"2017","journal-title":"Rheumatology (Oxford)"},{"key":"2026040708501390000_16.4.e114632.13","doi-asserted-by":"crossref","DOI":"10.3390\/biomedicines10071480","article-title":"Safety and Effectiveness of Abatacept in a Prospective Cohort of Patients with Rheumatoid Arthritis-Associated Interstitial Lung Disease","volume":"10","author":"Mena-V\u00e1zquez","year":"2022","journal-title":"Biomedicines"},{"key":"2026040708501390000_16.4.e114632.14","unstructured":"Optum for Business . Optum claims data: clinformatics data mart 2025. Available: https:\/\/business.optum.com\/content\/dam\/noindex-resources\/business\/pdfs\/sell-sheets\/ols-cdm-sellsheet.pdf [Accessed 12 Aug 2025]."},{"key":"2026040708501390000_16.4.e114632.15","unstructured":"Observational Medical Outcomes Partnership (OMOP) . OMOP common data model 2025. Available: https:\/\/ohdsi.github.io\/CommonDataModel\/ [Accessed 5 Feb 2025]."},{"key":"2026040708501390000_16.4.e114632.16","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1093\/jamia\/ocad247","article-title":"OHDSI Standardized Vocabularies-a large-scale centralized reference ontology for international data harmonization","volume":"31","author":"Reich","year":"2024","journal-title":"J Am Med Inform Assoc"},{"key":"2026040708501390000_16.4.e114632.17","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1513\/AnnalsATS.202102-222OC","article-title":"Claims-based Prevalence of Disease Progression among Patients with Fibrosing Interstitial Lung Disease Other than Idiopathic Pulmonary Fibrosis in the United States","volume":"19","author":"Singer","year":"2022","journal-title":"Ann Am Thorac Soc"},{"key":"2026040708501390000_16.4.e114632.18","doi-asserted-by":"publisher","DOI":"10.3233\/shti231108"},{"key":"2026040708501390000_16.4.e114632.19","unstructured":"OHDSI . ATLAS. Available: https:\/\/github.com\/OHDSI\/Atlas\/releases\/tag\/v2.14.1 [Accessed 15 Jun 2025]."},{"key":"2026040708501390000_16.4.e114632.20","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq433"},{"key":"2026040708501390000_16.4.e114632.21","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202202-0399ST"},{"key":"2026040708501390000_16.4.e114632.22","unstructured":"DailyMed . Label: prednisone tablet: national library of medicine. 2025. Available: https:\/\/dailymed.nlm.nih.gov\/dailymed\/drugInfo.cfm?setid=aa0b1582-6ef3-4697-9ea6-5391e6e57853 [Accessed 19 Aug 2025]."},{"key":"2026040708501390000_16.4.e114632.23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055120"},{"key":"2026040708501390000_16.4.e114632.24","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S2213-2600(16)30152-7","article-title":"Mycophenolate mofetil versus oral cyclophosphamide in scleroderma-related interstitial lung disease (SLS II): a randomised controlled, double-blind, parallel group trial","volume":"4","author":"Tashkin","year":"2016","journal-title":"Lancet Respir Med"},{"key":"2026040708501390000_16.4.e114632.25","unstructured":"Food and Drug Administration . FDA label for nda 205832. Available: https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2020\/205832s013lbl.pdf [Accessed 30 Apr 2024]."},{"key":"2026040708501390000_16.4.e114632.26","unstructured":"Food and Drug Administration . Highlights of prescribing information. Available: https:\/\/www.gene.com\/download\/pdf\/actemra_prescribing.pdf [Accessed 26 Aug 2025]."},{"key":"2026040708501390000_16.4.e114632.27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjresp-2013-000007","article-title":"A qualitative study of informal caregivers\u2019 perspectives on the effects of idiopathic pulmonary fibrosis","volume":"1","author":"Belkin","year":"2014","journal-title":"BMJ Open Respir Res"},{"key":"2026040708501390000_16.4.e114632.28","doi-asserted-by":"crossref","first-page":"1188","DOI":"10.1016\/j.chest.2019.11.042","article-title":"Disease Severity and Quality of Life in Patients With Idiopathic Pulmonary Fibrosis: A Cross-Sectional Analysis of the IPF-PRO Registry","volume":"157","author":"O\u2019Brien","year":"2020","journal-title":"Chest"},{"key":"2026040708501390000_16.4.e114632.29","doi-asserted-by":"crossref","DOI":"10.3390\/jcm10214830","article-title":"Interstitial Lung Disease in Connective Tissue Diseases: Survival Patterns in a Population-Based Cohort","volume":"10","author":"Hyldgaard","year":"2021","journal-title":"J Clin Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-114632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T15:50:28Z","timestamp":1775577028000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-114632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,7]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bmjopen-2025-114632"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-114632","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}