Treatment trajectories by radiologic pattern of lung injury in interstitial lung disease with myositis-associated antibodies: a retrospective cohort study.

Authors

Kevin Grudzinski, Thomas C Bolig, Malek Shawabkeh, Kavitha C Selvan, Raymond J Goodwin, Emily Olson, Bradford C Bemiss, Nishant Parekh, Hatice Savas, Jane E Dematte, Anthony J Esposito

Published in

Rheumatology advances in practice. Volume 10. Issue 4. Pages rkag128. Epub Oct 20, 2026.

Abstract

Lung involvement in interstitial lung disease (ILD) with myositis-associated antibodies (myositis-ILD) predominantly has two radiologic patterns-nonspecific interstitial pneumonia (NSIP) and organizing pneumonia (OP)-that often coexist, yet clinical outcomes of these patterns remain unclear. We aimed to describe functional and radiologic trajectories during immunomodulatory therapy by predominant radiologic pattern in myositis-ILD.
In this retrospective, single-centre cohort study, we studied participants from the Northwestern University ILD Registry with a circulating myositis-associated antibody, ILD, and at least 6 months of immunomodulatory therapy during a 24-month observation period. Two thoracic radiologists assigned the predominant radiologic pattern (NSIP or OP). The primary outcome was the change in forced vital capacity (FVC); secondary outcomes were the change in diffusing capacity of the lungs for carbon monoxide (DLCO) and qualitative and quantitative (Kazerooni score) radiologic change. Groups were compared with Fisher exact and Wilcoxon rank-sum tests.
Forty-one participants were characterized (29 [71%] OP-predominant, 12 [29%] NSIP-predominant). Both subgroups had improved FVC on immunomodulatory therapy (OP +0.36 l [P = 0.006]; NSIP +0.25 l [P = 0.09]). DLCO did not change significantly in either subgroup (OP +1.22 [P = 0.11]; NSIP -0.75 [P = 0.37]). The OP cohort improved on qualitative imaging analysis (P < 0.05), driven by reduced groundglass/consolidative opacity (P = 0.006). Participants with NSIP/OP overlap had greater baseline radiologic severity.
In myositis-ILD, both radiologic subgroups showed measurable functional and radiologic change during immunomodulatory therapy, with larger improvements in the OP-predominant subgroup; the magnitude of change did not differ significantly between subgroups. These descriptive, hypothesis-generating findings require multicentre validation.

PMID:
42967119
Bibliographic data and abstract were imported from PubMed on 01 Nov 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.