#3-25E. Evolving Paradigms: Treatment Patterns and Outcomes in SSc-ILD (Arthritis Rheumatol, 2025)

How have advancements in immunosuppressive strategies transformed the prognosis of Systemic Sclerosis-associated Interstitial Lung Disease (SSc-ILD) over the last two decades? This pivotal study utilizes the EUSTAR database to track 1,409 patients, analyzing the evolution of treatment patterns from the pre-2006 era to the present day. The researchers document a substantial paradigm shift, with immunosuppressive usage surging from 13.6% to 57.4%, driven largely by the adoption of mycophenolate mofetil and novel combination regimens. The study's most compelling finding is the concurrent reduction in ILD progression rates, which fell significantly from 21.3% to 12.1%, suggesting a tangible benefit from these evolving therapeutic strategies12. Critically, however, the study lacks serial high-resolution CT data and detailed safety reports, meaning radiological progression and drug toxicity remain potential blind spots in this real-world analysis3. For the practicing rheumatologist and pulmonologist, this evidence supports a proactive approach, highlighting that early initiation of immunosuppressive or combination therapy is associated with improved lung stability in a real-world clinical setting.

Citation: CAMPOCHIARO, C., et al. Impact of evolving treatment patterns on interstitial lung disease progression in systemic sclerosis using the EUSTAR database. Arthritis & Rheumatology. 2025. DOI: 10.1002/art.70043

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