{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:53:45Z","timestamp":1788980025309,"version":"build-2803163510"},"reference-count":49,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Antibodies against Ku have been described in patients with various connective tissue diseases. The objective of this study was to describe the clinical, functional, and imaging characteristics of interstitial lung disease in patients with anti-Ku antibodies. Methods: This single-center, retrospective observational study was conducted at a tertiary referral institution. Patients with positive anti-Ku antibodies and interstitial lung disease identified between 2007 and 2022 were included. Clinical, immunological, functional, and imaging data were systematically reviewed. Results: Nineteen patients (ten females) with a mean age of 59 \u00b1 12.6 years were included. The most frequent associated diagnosis was systemic sclerosis (42%), followed by rheumatoid arthritis (26%), Sj\u00f6gren syndrome, undifferentiated connective tissue disease, and overlap between systemic sclerosis and idiopathic inflammatory myopathy (scleromyositis). Imaging revealed frequent septal and intralobular reticulations and ground-glass opacities, with nonspecific interstitial pneumonia as the predominant pattern (53%). The mean forced vital capacity was 82% \u00b1 26 of the predicted value, and the mean diffusing capacity for carbon monoxide was 55% \u00b1 21. Over the first year of follow-up, the mean annual forced vital capacity decline was 140 mL\/year (range: 0\u20131610 mL\/year). The overall survival rate was 82% at 5 years and 67% at 10 years. Conclusions: Most patients with interstitial lung disease and anti-Ku antibodies presented with dyspnea, a mild-to-moderate restrictive ventilatory pattern, and reduced diffusing capacity for carbon monoxide. The CT pattern was heterogeneous but was consistent with nonspecific interstitial pneumonia in half of the patients.<\/jats:p>","DOI":"10.3390\/jcm14010247","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T07:10:17Z","timestamp":1735888217000},"page":"247","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Interstitial Lung Disease Associated with Anti-Ku Antibodies: A Case Series of 19 Patients"],"prefix":"10.3390","volume":"14","author":[{"given":"Laure","family":"Petitgrand","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, European Reference Network (ERN)-LUNG, 28 Avenue Doyen Lepine, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka\u00efs","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, European Reference Network (ERN)-LUNG, 28 Avenue Doyen Lepine, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Gamond\u00e8s","sequence":"additional","affiliation":[{"name":"Radiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0746-357X","authenticated-orcid":false,"given":"R\u00e9mi","family":"Diesler","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, European Reference Network (ERN)-LUNG, 28 Avenue Doyen Lepine, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Fabien","sequence":"additional","affiliation":[{"name":"Immunology Department, Lyon-Sud Hospital, Hospices Civils de Lyon, 69149 Pierre B\u00e9nite, France"},{"name":"Immunogenomics and Inflammation Research Team, Facult\u00e9 Lyon Sud, Claude Bernard University Lyon 1, 69367 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7020-1954","authenticated-orcid":false,"given":"Laure","family":"Gallay","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Edouard Herriot Hospital, Hospices Civils de Lyon, 69367 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Fort","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care Unit, Lyon Sud Hospital, Hospices Civils de Lyon, 69149 Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Traclet","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, European Reference Network (ERN)-LUNG, 28 Avenue Doyen Lepine, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Lestelle","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, European Reference Network (ERN)-LUNG, 28 Avenue Doyen Lepine, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Chapurlat","sequence":"additional","affiliation":[{"name":"INSERM UMR 1033, Facult\u00e9 Lyon Sud, Universit\u00e9 Claude Bernard-Lyon 1, Edouard Herriot Hospital, 69367 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9318-6785","authenticated-orcid":false,"given":"Cyrille B.","family":"Confavreux","sequence":"additional","affiliation":[{"name":"INSERM UMR 1033, Facult\u00e9 Lyon Sud, Universit\u00e9 Claude Bernard-Lyon 1, Edouard Herriot Hospital, 69367 Lyon, France"},{"name":"Rheumatology Department, Lyon Sud Hospital, Cancer Institute of Hospices Civils de Lyon, 69003 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Durupt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, 69149 Pierre B\u00e9nite, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5894-4491","authenticated-orcid":false,"given":"S\u00e9gol\u00e8ne","family":"Turquier","sequence":"additional","affiliation":[{"name":"Pulmonary Physiology, Louis Pradel Hospital, Hospices Civils de Lyon, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0314-4010","authenticated-orcid":false,"given":"Salim Aymeric","family":"Si-Mohamed","sequence":"additional","affiliation":[{"name":"Radiology Department, Louis Pradel Hospital, Hospices Civils de Lyon, 69677 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2485-5284","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Coutant","sequence":"additional","affiliation":[{"name":"Immunology Department, Lyon-Sud Hospital, Hospices Civils de Lyon, 69149 Pierre B\u00e9nite, France"},{"name":"Immunogenomics and Inflammation Research Team, Facult\u00e9 Lyon Sud, Claude Bernard University Lyon 1, 69367 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5591-0955","authenticated-orcid":false,"given":"Vincent","family":"Cottin","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, National Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, European Reference Network (ERN)-LUNG, 28 Avenue Doyen Lepine, 69677 Lyon, France"},{"name":"UMR 754, INRAE, Facult\u00e9 Lyon Est, Claude Bernard University Lyon 1, 69367 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1056\/NEJMra2005230","article-title":"Spectrum of Fibrotic Lung Diseases","volume":"383","author":"Wijsenbeek","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"220210","DOI":"10.1183\/16000617.0210-2022","article-title":"Prevalence, imaging patterns and risk factors of interstitial lung disease in connective tissue disease: A systematic review and meta-analysis","volume":"32","author":"Joy","year":"2023","journal-title":"Eur. Respir. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/S0140-6736(22)01052-2","article-title":"Interstitial lung diseases","volume":"400","author":"Wijsenbeek","year":"2022","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/S2213-2600(17)30433-2","article-title":"Diagnostic criteria for idiopathic pulmonary fibrosis: A Fleischner Society White Paper","volume":"6","author":"Lynch","year":"2018","journal-title":"Lancet Respir. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1183\/13993003.00150-2015","article-title":"An official European Respiratory Society\/American Thoracic Society research statement: Interstitial pneumonia with autoimmune features","volume":"46","author":"Fischer","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1528","DOI":"10.1001\/jamaneurol.2018.2598","article-title":"Development of a New Classification System for Idiopathic Inflammatory Myopathies Based on Clinical Manifestations and Myositis-Specific Autoantibodies","volume":"75","author":"Mariampillai","year":"2018","journal-title":"JAMA Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3234","DOI":"10.1002\/art.39316","article-title":"Interpretation of an Extended Autoantibody Profile in a Well-Characterized Australian Systemic Sclerosis (Scleroderma) Cohort Using Principal Components Analysis","volume":"67","author":"Patterson","year":"2015","journal-title":"Arthritis Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1183\/09031936.03.00026703","article-title":"Interstitial lung disease in amyopathic dermatomyositis, dermatomyositis and polymyositis","volume":"22","author":"Cottin","year":"2003","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.autrev.2012.06.006","article-title":"Hierarchical cluster and survival analyses of antisynthetase syndrome: Phenotype and outcome are correlated with anti-tRNA synthetase antibody specificity","volume":"12","author":"Hervier","year":"2012","journal-title":"Autoimmun. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.3899\/jrheum.090652","article-title":"Interstitial Lung Disease Associated with Anti-PM\/Scl or Anti-Aminoacyl-tRNA Synthetase Autoantibodies: A Similar Condition?","volume":"37","author":"Lega","year":"2010","journal-title":"J. Rheumatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1055\/s-0044-1786698","article-title":"Interstitial Lung Disease Associated with Systemic Sclerosis","volume":"45","author":"Mismetti","year":"2024","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1055\/s-0039-1685187","article-title":"Lung Diseases in Inflammatory Myopathies","volume":"40","author":"Barba","year":"2019","journal-title":"Semin. Respir. Crit. Care. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1111\/j.1365-2133.2009.09484.x","article-title":"Long-term outcome of patients with polymyositis\/dermatomyositis and anti-PM-Scl antibody","volume":"162","author":"Marie","year":"2010","journal-title":"Br. J. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.semarthrit.2014.07.002","article-title":"Good outcome of interstitial lung disease in patients with scleroderma associated to anti-PM\/Scl antibody","volume":"44","author":"Munoz","year":"2014","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.mrrev.2014.06.002","article-title":"The Ku heterodimer: Function in DNA repair and beyond","volume":"763","author":"Fell","year":"2015","journal-title":"Mutat. Res. Rev. Mutat. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2201383","DOI":"10.1183\/13993003.01383-2022","article-title":"European Respiratory Society statement on familial pulmonary fibrosis","volume":"61","author":"Borie","year":"2023","journal-title":"Eur. Respir. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1172\/JCI110295","article-title":"Characterization of a high molecular weight acidic nuclear protein recognized by autoantibodies in sera from patients with polymyositis-scleroderma overlap","volume":"68","author":"Mimori","year":"1981","journal-title":"J. Clin. Investig."},{"key":"ref_18","first-page":"1393","article-title":"Anti-Ku antibodies in connective tissue diseases: Clinical and serological evaluation of 14 patients","volume":"29","author":"Franceschini","year":"2002","journal-title":"J. Rheumatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e4713","DOI":"10.1097\/MD.0000000000004713","article-title":"Single-specificity anti-Ku antibodies in an international cohort of 2140 systemic sclerosis subjects: Clinical associations","volume":"95","author":"Hoa","year":"2016","journal-title":"Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1136\/ard.2007.073981","article-title":"Prevalence and clinical associations of anti-Ku antibodies in patients with systemic sclerosis: A European EUSTAR-initiated multi-centre case-control study","volume":"67","author":"Rozman","year":"2008","journal-title":"Ann. Rheum. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"909","DOI":"10.6061\/clinics\/2013(07)04","article-title":"Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis","volume":"68","author":"Cruellas","year":"2013","journal-title":"Clinics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1177\/0961203308089442","article-title":"Prevalence and clinical associations of anti-Ku antibodies in systemic autoimmune diseases","volume":"17","author":"Cavazzana","year":"2008","journal-title":"Lupus"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1136\/ard.2009.114264","article-title":"Causes and risk factors for death in systemic sclerosis: A study from the EULAR Scleroderma Trials and Research (EUSTAR) database","volume":"69","author":"Tyndall","year":"2010","journal-title":"Ann. Rheum. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.autrev.2010.05.020","article-title":"Anti-Ku antibodies: Clinical, genetic and diagnostic insights","volume":"9","author":"Belizna","year":"2010","journal-title":"Autoimmun. Rev."},{"key":"ref_25","first-page":"563","article-title":"Clinical and serological associations of anti-Ku antibody","volume":"26","author":"Cooley","year":"1999","journal-title":"J. Rheumatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1136\/annrheumdis-2018-214439","article-title":"Anti-Ku syndrome with elevated CK and anti-Ku syndrome with anti-dsDNA are two distinct entities with different outcomes","volume":"78","author":"Spielmann","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e48","DOI":"10.1136\/annrheumdis-2020-217096","article-title":"Immune-mediated necrotizing myopathies and interstitial lung disease are predominant characteristics in anti-Ku positive patients with idiopathic inflammatory myopathies","volume":"81","author":"Yang","year":"2022","journal-title":"Ann. Rheum. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/MD.0b013e31824d9cec","article-title":"Inflammatory Myopathies With Anti-Ku Antibodies","volume":"91","author":"Rigolet","year":"2012","journal-title":"Medicine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.semarthrit.2021.04.012","article-title":"The phenotype of myositis patients with anti-Ku autoantibodies","volume":"51","author":"Derfoul","year":"2021","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s00401-024-02765-3","article-title":"Anti-Ku\u2009+\u2009myositis: An acquired inflammatory protein-aggregate myopathy","volume":"148","author":"Holzer","year":"2024","journal-title":"Acta Neuropathol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e209268","DOI":"10.1212\/WNL.0000000000209268","article-title":"Pathologic Features of Anti-Ku Myositis","volume":"102","author":"Oyama","year":"2024","journal-title":"Neurology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e268","DOI":"10.1093\/rheumatology\/keae199","article-title":"Increased risk of myocarditis and arrythmias in anti-Ku-positive scleroderma-myositis overlap patients: A case series","volume":"63","author":"Bhalodia","year":"2024","journal-title":"Rheumatology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e213","DOI":"10.1093\/rheumatology\/kead049","article-title":"Anti-Ku antibody syndrome: Is it a distinct clinical entity? A cross-sectional study of 75 patients","volume":"62","author":"Sousa","year":"2023","journal-title":"Rheumatology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1055\/s-0044-1782218","article-title":"Overview of Rheumatoid Arthritis-Associated Interstitial Lung Disease and Its Treatment","volume":"45","author":"Pugashetti","year":"2024","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/his.12415","article-title":"Prognostic relevance of histological variants in nonspecific interstitial pneumonia","volume":"65","author":"Kambouchner","year":"2014","journal-title":"Histopathology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"106201","DOI":"10.1016\/j.rmed.2020.106201","article-title":"Clinical, radiological, and pathological evaluation of \"NSIP with OP overlap\" pattern compared with NSIP in patients with idiopathic interstitial pneumonias","volume":"174","author":"Enomoto","year":"2020","journal-title":"Respir. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1148\/radiol.2322031223","article-title":"CT features of lung disease in patients with systemic sclerosis: Comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia","volume":"232","author":"Desai","year":"2004","journal-title":"Radiology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2109","DOI":"10.1093\/rheumatology\/keaa021","article-title":"The reliability of immunoassays to detect autoantibodies in patients with myositis is dependent on autoantibody specificity","volume":"59","author":"Tansley","year":"2020","journal-title":"Rheumatology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1093\/rheumatology\/key451","article-title":"Combining immunofluorescence with immunoblot assay improves the specificity of autoantibody testing for myositis","volume":"58","author":"Infantino","year":"2019","journal-title":"Rheumatology"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.autrev.2018.10.004","article-title":"Autoantibodies in idiopathic inflammatory myopathies: Clinical associations and laboratory evaluation by mono- and multispecific immunoassays","volume":"18","author":"Damoiseaux","year":"2019","journal-title":"Autoimmun. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1007\/s12026-015-8774-6","article-title":"Heterogeneous clinical spectrum of anti-SRP myositis and importance of the methods of detection of anti-SRP autoantibodies: A multicentric study","volume":"64","author":"Picard","year":"2016","journal-title":"Immunol. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e182","DOI":"10.1136\/annrheumdis-2019-216535","article-title":"Anti-Ku antibodies: Important points to consider","volume":"80","author":"Mahler","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1136\/annrheumdis-2021-eular.1067","article-title":"Progressive interstitial lung disease in patients with systemic sclerosis-associated interstitial lung disease in the EUSTAR database","volume":"80","author":"Allanore","year":"2021","journal-title":"Ann. Rheum. Dis."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2518","DOI":"10.1056\/NEJMoa1903076","article-title":"Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease","volume":"380","author":"Distler","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1164\/rccm.202306-1113ST","article-title":"Treatment of Systemic Sclerosis-associated Interstitial Lung Disease: Evidence-based Recommendations. An Official American Thoracic Society Clinical Practice Guideline","volume":"209","author":"Raghu","year":"2024","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1002\/art.42861","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 Rheumatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1016\/S2213-2600(20)30318-0","article-title":"Tocilizumab in systemic sclerosis: A randomised, double-blind, placebo-controlled, phase 3 trial","volume":"8","author":"Khanna","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e489","DOI":"10.1016\/S2665-9913(21)00107-7","article-title":"Safety and efficacy of rituximab in systemic sclerosis (DESIRES): A double-blind, investigator-initiated, randomised, placebo-controlled trial","volume":"3","author":"Ebata","year":"2021","journal-title":"Lancet Rheumatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"220003","DOI":"10.1183\/16000617.0003-2022","article-title":"Multidisciplinary teams in the clinical care of fibrotic interstitial lung disease: Current perspectives","volume":"31","author":"Cottin","year":"2022","journal-title":"Eur. Respir. Rev."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/1\/247\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:22:28Z","timestamp":1759918948000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/1\/247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":49,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["jcm14010247"],"URL":"https:\/\/doi.org\/10.3390\/jcm14010247","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,3]]}}}