Work

Real-world care patterns and specialist encounters of patients with systemic autoimmune rheumatic disease-related interstitial lung disease in the United States: a retrospective administrative claims database analysis

Year: 2025

Type: article

Abstract: OBJECTIVES: We aimed to describe the demographics, clinical characteristics and care patterns of patients with systemic autoimmune rheumatic diseases (SARD) prior to their interstitial lung disease (ILD) diagnosis. METHODS: We conducted a retrospective cohort study using claims data from Healthcare Integrated Research Database (2006-2023). Adults diagnosed with SARD-ILD were identified, with the earliest ILD diagnosis date designated as the index date. A minimum of 36 months of continuous enrolment before the index date was required. All measures were analysed descriptively. For a subset of patients with respiratory symptoms before ILD diagnosis, the association between type of specialist encounter and time from symptom onset to SARD-ILD diagnosis was assessed using a Cox proportional hazards model. RESULTS: The study included 2526 patients with SARD-ILD. Mean age was 62.6 years and 75.4% were female. Before ILD diagnosis, 61.8% of patients had at least one all-cause hospitalization. Diagnostic tests including chest CT, high-resolution CT, and pulmonary function tests (PFT) were used in 80.1%, 59.0% and 60.3% of patients, respectively. Among the subgroup, patients who saw a pulmonologist within 90 days of initial respiratory symptom onset were 18% more likely to be diagnosed with ILD compared with those who did not (hazard ratio: 1.18, 95% CI: 1.03, 1.35; P = 0.017). CONCLUSION: The study highlights the complex diagnostic journey of patients with SARD-ILD. Findings suggest a multidisciplinary approach involving pulmonologists and rheumatologists could enable timely ILD diagnosis and should be considered for more effective diagnosis and management of SARD-ILD.

Source: Lara D. Veeken

DOI: 10.1093/rheumatology/keaf200