{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:15:38Z","timestamp":1790612138497,"version":"4.1.0"},"reference-count":33,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"unspecified","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["01EC1902A"],"award-info":[{"award-number":["01EC1902A"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,1,11]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To investigate prevalence, incidence and medication of interstitial lung disease (ILD) among German individuals with rheumatoid arthritis (RA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Nationwide BARMER claims data from 2007 to 2020 were used. RA-ILD was identified by diagnosis codes, prescription of disease-modifying antirheumatic drugs (DMARDs) and lung diagnostics. ILD was assigned as incident or prevalent relative to the year of the first diagnosis. We identified prescriptions of glucocorticoids, conventional synthetic (cs), biological (b) and targeted synthetic (ts)DMARDs, antifibrotics and rheumatology and\/or pulmonology care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among all persons with RA (40\u2009686 in 2007 to 85\u2009175 in 2020), 1.7%\u20132.2%\/year had ILD with a slight decline since 2013. Incident ILD was 0.13%\u20130.21% per year and remained stable over time. ILD was more common in seropositive RA, in men and in the elderly (mean age 72 years in 2020). Glucocorticoids (84% to 68%), csDMARD (83% to 55%) and non-steroidal anti-inflammatory drug use (62% to 38%) declined, while bDMARDs (16% to 24%) rose. In 2020, 7% received tsDMARDs, 3% antifibrotics, 44% analgesics and 30% opioids. DMARD therapy was more common if a rheumatologist was involved and antifibrotics if a pulmonologist was involved. Opioid use was highest if no specialist was involved (39%) but also common in rheumatology care (32%) and less frequent in pulmonology care (21%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>RA-ILD is rare and mainly affects elderly persons. No trend in incidence was observed but treatment strategies have enlarged. Specialist care is necessary to provide disease-specific therapies. The continuing high analgesic and opioid demand shows unmet needs in these patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2022-002777","type":"journal-article","created":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T11:38:09Z","timestamp":1674214689000},"page":"e002777","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Interstitial lung disease in rheumatoid arthritis: incidence, prevalence and related drug prescriptions between 2007 and 2020"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0886-0294","authenticated-orcid":false,"given":"Katinka","family":"Albrecht","sequence":"first","affiliation":[{"name":"Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-022X","authenticated-orcid":false,"given":"Anja","family":"Strangfeld","sequence":"additional","affiliation":[{"name":"Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Germany"},{"name":"Department of Rheumatology and Clinical Immunology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ursula","family":"Marschall","sequence":"additional","affiliation":[{"name":"Department Medicine and Health Services Research, BARMER Institute for Health System Research, Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3923-2728","authenticated-orcid":false,"given":"Johanna","family":"Callhoff","sequence":"additional","affiliation":[{"name":"Epidemiology and Health Services Research, German Rheumatism Research Centre, Berlin, Germany"},{"name":"Institute for Social Medicine, Epidemiology and Health Economics, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"2025090312594339000_9.1.e002777.1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1159\/000502551","article-title":"Rheumatoid arthritis-associated interstitial lung disease: clinical characteristics and predictors of mortality","volume":"98","author":"Hyldgaard","year":"2019","journal-title":"Respiration"},{"key":"2025090312594339000_9.1.e002777.2","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1002\/art.40574","article-title":"The lung in rheumatoid arthritis: focus on interstitial lung disease","volume":"70","author":"Spagnolo","year":"2018","journal-title":"Arthritis Rheumatol"},{"key":"2025090312594339000_9.1.e002777.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211138"},{"key":"2025090312594339000_9.1.e002777.4","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3389\/fmed.2019.00238","article-title":"Methotrexate-associated pneumonitis and rheumatoid arthritis-interstitial lung disease: current concepts for the diagnosis and treatment","volume":"6","author":"Fragoulis","year":"2019","journal-title":"Front Med (Lausanne)"},{"key":"2025090312594339000_9.1.e002777.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-028466","article-title":"Is incident rheumatoid arthritis interstitial lung disease associated with methotrexate treatment? Results from a multivariate analysis in the ERas and ERAN inception cohorts","volume":"9","author":"Kiely","year":"2019","journal-title":"BMJ Open"},{"key":"2025090312594339000_9.1.e002777.6","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa836"},{"key":"2025090312594339000_9.1.e002777.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.27405"},{"key":"2025090312594339000_9.1.e002777.8","doi-asserted-by":"crossref","first-page":"2042","DOI":"10.1002\/acr.24856","article-title":"Incidence, risk factors, and mortality of clinical and subclinical rheumatoid arthritis-associated interstitial lung disease: a population-based cohort","volume":"74","author":"Samhouri","year":"2022","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025090312594339000_9.1.e002777.9","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.1007\/s10067-019-04720-0","article-title":"Progressive fibrosing interstitial lung disease associated with systemic autoimmune diseases","volume":"38","author":"Fischer","year":"2019","journal-title":"Clin Rheumatol"},{"key":"2025090312594339000_9.1.e002777.10","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1007\/s00393-020-00829-9","article-title":"Interstitial lung disease (ILD) -when and how to treat","volume":"79","author":"Kr\u00fcger","year":"2020","journal-title":"Z Rheumatol"},{"key":"2025090312594339000_9.1.e002777.11","doi-asserted-by":"crossref","first-page":"4861","DOI":"10.1007\/s10067-021-05854-w","article-title":"Abatacept in rheumatoid arthritis-associated interstitial lung disease: short-term outcomes and predictors of progression","volume":"40","author":"Tardella","year":"2021","journal-title":"Clin Rheumatol"},{"key":"2025090312594339000_9.1.e002777.12","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1111\/imj.14670","article-title":"Tocilizumab therapy in rheumatoid arthritis with interstitial lung disease: a multicentre retrospective study","volume":"50","author":"Manfredi","year":"2020","journal-title":"Intern Med J"},{"key":"2025090312594339000_9.1.e002777.13","doi-asserted-by":"crossref","DOI":"10.3390\/jcm8122038","article-title":"Interstitial lung disease in rheumatoid arthritis remains a challenge for clinicians","volume":"8","author":"Bendstrup","year":"2019","journal-title":"J Clin Med"},{"key":"2025090312594339000_9.1.e002777.14","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2022-eular.1539"},{"key":"2025090312594339000_9.1.e002777.15","doi-asserted-by":"crossref","unstructured":"Callhoff J , Albrecht K , Marschall U , et al . Identification of rheumatoid arthritis in german claims data using different algorithms: validation by cross-sectional patient-reported survey data. Pharmacoepidemiol Drug Saf 2022; doi:10.1002\/pds.5562","DOI":"10.1002\/pds.5562"},{"key":"2025090312594339000_9.1.e002777.16","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-021-02655-z","article-title":"Validation of an algorithm to identify incident interstitial lung disease in patients with rheumatoid arthritis","volume":"24","author":"Meehan","year":"2022","journal-title":"Arthritis Res Ther"},{"key":"2025090312594339000_9.1.e002777.17","unstructured":"World Health Organisation W . ATC-DDD toolkit. defined daily dose (DDD). 2022. Available: https:\/\/www.who.int\/tools\/atc-ddd-toolkit\/about-ddd [Accessed 27 Sep 2022]."},{"key":"2025090312594339000_9.1.e002777.18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001885","article-title":"The reporting of studies conducted using observational routinely-collected health data (record) statement","volume":"12","author":"Benchimol","year":"2015","journal-title":"PLoS Med"},{"key":"2025090312594339000_9.1.e002777.19","first-page":"344","article-title":"Patterns of interstitial lung disease and mortality in rheumatoid arthritis","volume":"56","author":"Zamora-Legoff","year":"2017","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312594339000_9.1.e002777.20","first-page":"1280","article-title":"Association between chronic obstructive pulmonary disease, smoking, and interstitial lung disease onset in rheumatoid arthritis","volume":"40","author":"Zheng","year":"2022","journal-title":"Clin Exp Rheumatol"},{"key":"2025090312594339000_9.1.e002777.21","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.171315"},{"key":"2025090312594339000_9.1.e002777.22","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.200863"},{"key":"2025090312594339000_9.1.e002777.23","doi-asserted-by":"crossref","first-page":"3906","DOI":"10.1093\/rheumatology\/keaa621","article-title":"Abatacept in interstitial lung disease associated with rheumatoid arthritis: national multicenter study of 263 patients","volume":"59","author":"Fern\u00e1ndez-D\u00edaz","year":"2020","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312594339000_9.1.e002777.24","doi-asserted-by":"crossref","first-page":"102830","DOI":"10.1016\/j.autrev.2021.102830","article-title":"Efficacy and safety of abatacept in interstitial lung disease of rheumatoid arthritis: a systematic literature review","volume":"20","author":"Vicente-Rabaneda","year":"2021","journal-title":"Autoimmun Rev"},{"key":"2025090312594339000_9.1.e002777.25","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1093\/rheumatology\/keab317","article-title":"Abatacept in monotherapy vs combined in interstitial lung disease of rheumatoid arthritis-multicentre study of 263 caucasian patients","volume":"61","author":"Fern\u00e1ndez-D\u00edaz","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312594339000_9.1.e002777.26","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":"2025090312594339000_9.1.e002777.27","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kez177"},{"key":"2025090312594339000_9.1.e002777.28","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1093\/rheumatology\/kez673","article-title":"Efficacy of rituximab in slowing down progression of rheumatoid arthritis-related interstitial lung disease: data from the NEREA registry","volume":"59","author":"Vadillo","year":"2020","journal-title":"Rheumatology (Oxford)"},{"key":"2025090312594339000_9.1.e002777.29","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-015-0835-7"},{"key":"2025090312594339000_9.1.e002777.30","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1007\/s00296-021-04835-1","article-title":"A retrospective comparison of respiratory events with JAK inhibitors or rituximab for rheumatoid arthritis in patients with pulmonary disease","volume":"41","author":"Cronin","year":"2021","journal-title":"Rheumatol Int"},{"key":"2025090312594339000_9.1.e002777.31","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1007\/s10787-022-00936-w","article-title":"A retrospective study of the efficacy of JAK inhibitors or abatacept on rheumatoid arthritis-interstitial lung disease","volume":"30","author":"Tardella","year":"2022","journal-title":"Inflammopharmacology"},{"key":"2025090312594339000_9.1.e002777.32","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.semarthrit.2020.04.006","article-title":"Validation of claims-based algorithms to identify interstitial lung disease in patients with rheumatoid arthritis","volume":"50","author":"Cho","year":"2020","journal-title":"Semin Arthritis Rheum"},{"key":"2025090312594339000_9.1.e002777.33","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s00393-021-00971-y","article-title":"Prescription of analgesics in patients with rheumatic diseases in germany: a claims data analysis","volume":"80","author":"Albrecht","year":"2021","journal-title":"Z Rheumatol"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2022-002777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:59:51Z","timestamp":1756929591000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2022-002777"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,20]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/rmdopen-2022-002777"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2022-002777","relation":{},"ISSN":["2056-5933"],"issn-type":[{"value":"2056-5933","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}