medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2026-12-49-56medalphabet-5129Research ArticleСтатьиРевматоидный артрит и интерстициальные заболевания легких: современные подходы к терапииRheumatoid arthritis and interstitial lung diseases: modern approaches to therapyhttps://orcid.org/0000-0001-7091-2054БеловБ. С.BelovB. S.

Белов Борис Сергеевич, д. м. н., зав. лабораторией ревматоидного артрита и коморбидных инфекций

Belov Boris S., Dr Med Sci (habil.), head of the Laboratory of Rheumatoid Arthritis and Comorbid Infections

belovbor@yandex.ruhttps://orcid.org/0000-0003-4327-6720МуравьеваН. В.MuravyevaN. V.

Муравьева Наталья Валерьевна, к. м. н., старший научный сотрудник лаборатории ревматоидного артрита и коморбидных инфекций

Muravyeva Natalia V., PhD Med Sc, Senior Researcher at Laboratory of Rheumatoid Arthritis and Comorbid Infections

https://orcid.org/0009-0003-7319-8345СедельниковаМ. А.SedelnikovaM. A.

Седельникова Мария Андреевна, врач 3-го ревматологического отделения

Sedelnikova Marija A., physician of the 3rd Rheumatology Dept.

ФГБНУ «Научно-исследовательский институт ревматологии им. В. А. Насоновой»РоссияV. A. Nasonova Research Institute of RheumatologyRussian Federation202624062026012Ревматология в общей врачебной практике (1)4956Copyright © Белов Б.С., Муравьева Н.В., Седельникова М.А., 20262026Белов Б.С., Муравьева Н.В., Седельникова М.А.Belov B.S., Muravyeva N.V., Sedelnikova M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/5129

Интерстициальное заболевание легких (ИЗЛ) является наиболее тяжелым внесуставным проявлением ревматоидного артрита (РА) и одной из наиболее частых причин смерти этих пациентов. Лечение ИЗЛ при РА до сих пор остается предметом дискуссий. В идеале оно должно быть направлено на контроль активности суставной патологии, предотвращение ИЗЛ или замедление прогрессирования поражения легких, в частности фиброзных изменений. Противоревматические препараты, модифицирующие течение РА, используются в повседневной практике, но их эффективность при ИЗЛ не доказана, хотя хороший контроль системного заболевания может улучшить прогноз для пациентов. Иммунодепрессанты, обычно рекомендуемые для лечения ИЗЛ, связанного с иммуновоспалительным ревматическим заболеванием, часто обладают низкой эффективностью в отношении РА. Поэтому с целью определения оптимальной терапевтической стратегии для конкретного пациента обычно требуется междисциплинарное обсуждение, включающее как минимум ревматолога и пульмонолога. В данной статье будут рассмотрены доступные в настоящее время варианты лечения РА-ИЗЛ с акцентом на их возможное применение в соответствии с современными знаниями о патогенезе и клиническом развитии этого заболевания.

Interstitial lung disease (ILD) is the most severe extra-articular manifestation of rheumatoid arthritis (RA) and one of the most frequent causes of death in these patients. Treatment of ED in RA is still a subject of debate. Ideally, it should be aimed at controlling the activity of joint pathology, preventing healing or slowing the progression of lung damage, in particular fibrotic changes. Antirheumatic drugs that modify the course of RA are used in daily practice, but their effectiveness in ILD has not been proven, although good control of systemic disease can improve the prognosis for patients. Immunosuppressants, which are commonly recommended for the treatment of ILD associated with immune-inflammatory rheumatic disease, often have low efficacy against RA. Therefore, in order to determine the optimal therapeutic strategy for a particular patient, an interdisciplinary discussion is usually required, including at least a rheumatologist and a pulmonologist. This article will review the currently available RA-ILD treatment options, with an emphasis on their possible use in accordance with current knowledge about the pathogenesis and clinical development of this disease.

ревматоидный артритинтерстициальные заболевания легкихметотрексатглюкокортикоидыгенно-инженерные биологические препаратытаргетные базисные противовоспалительные препаратыантифибротические препаратыrheumatoid arthritisinterstitial lung diseasesmethotrexateglucocorticoidsbiological drugstargeted basic anti-inflammatory drugsantifibrotic drugsReferencesSmolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016; 388 (10055): 2023–2038. DOI: 10.1016/S0140-6736(16)30173-8Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet. 2016; 388 (10055): 2023–2038. DOI: 10.1016/S0140-6736(16)30173-8David M, Dieude P, Juge PA. et al. Rheumatoid arthritis-associated interstitial lung disease: A review. Respir Med Res. 2026; 89: 101260. DOI: 10.1016/j.resmer.2026.101260David M, Dieude P, Juge PA. et al. Rheumatoid arthritis-associated interstitial lung disease: A review. Respir Med Res. 2026; 89: 101260. DOI: 10.1016/j.resmer.2026.101260Laria A, Lurati AM, Zizzo G. et al. Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review. Front Med (Lausanne). 2022; 9: 837133. DOI: 10.3389/fmed.2022.837133Laria A, Lurati AM, Zizzo G. et al. Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review. Front Med (Lausanne). 2022; 9: 837133. DOI: 10.3389/fmed.2022.837133Насонов Е. Л., Ананьева Л. П., Авдеев С. Н. Интерстициальные заболевания легких при ревматоидном артрите: мультидисциплинарная проблема ревматологии и пульмонологии. Научно-практическая ревматология. 2022; 60 (6): 517–534.Nasonov E. L., Ananyeva L. P., Avdeev S. N. Interstitial lung disease in rheumatoid arthritis: A multidisciplinary problem in rheumatology and pulmonology. Nauchno-Prakticheskaya Revmatologia = Rheumatology Science and Practice. 2022; 60 (6): 517–534. (In Russ.). DOI: 10.47360/1995-4484-2022-1Hyldgaard C, Hilberg O, Pedersen AB. et al. A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: comorbidity and mortality. Ann Rheum Dis. 2017; 76 (10): 1700–1706. DOI: 10.1136/annrheumdis-2017-211138Hyldgaard C, Hilberg O, Pedersen AB. et al. A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease: comorbidity and mortality. Ann Rheum Dis. 2017; 76 (10): 1700–1706. DOI: 10.1136/annrheumdis-2017-211138Jeganathan N, Nguyen E, Sathananthan M. Rheumatoid Arthritis and Associated Interstitial Lung Disease: Mortality Rates and Trends. Ann Am Thorac Soc. 2021; 18 (12): 1970–1977. DOI: 10.1513/AnnalsATS.202102-115OCJeganathan N, Nguyen E, Sathananthan M. Rheumatoid Arthritis and Associated Interstitial Lung Disease: Mortality Rates and Trends. Ann Am Thorac Soc. 2021; 18 (12): 1970–1977. DOI: 10.1513/AnnalsATS.202102-115OCJohnson SR, Bernstein EJ, Bolster MB. et al. 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. Arthritis Care Res (Hoboken). 2024; 76 (8): 1051–1069. DOI: 10.1002/acr.25348Johnson SR, Bernstein EJ, Bolster MB. et al. 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. Arthritis Care Res (Hoboken). 2024; 76 (8): 1051–1069. DOI: 10.1002/acr.25348Narváez J, Díaz Del Campo Fontecha P, Brito García N. et al. SER-SEPAR recommendations for the management of rheumatoid arthritis-related interstitial lung disease. Part 2: Treatment. Reumatol Clin (Engl Ed). 2022 Nov; 18 (9): 501–512. DOI: 10.1016/j.reumae.2022.03.004Narváez J, Díaz Del Campo Fontecha P, Brito García N. et al. SER-SEPAR recommendations for the management of rheumatoid arthritis-related interstitial lung disease. Part 2: Treatment. Reumatol Clin (Engl Ed). 2022 Nov; 18 (9): 501–512. DOI: 10.1016/j.reumae.2022.03.004Crotti C, Ughi N, Scirè CA, et al. The Italian Society for Rheumatology guidelines for the treatment of patients with rheumatoid arthritis and interstitial lung disease. Reumatismo. 2026 Mar 16; 78 (1). DOI: 10.4081/reumatismo.2025.1865Crotti C, Ughi N, Scirè CA, et al. The Italian Society for Rheumatology guidelines for the treatment of patients with rheumatoid arthritis and interstitial lung disease. Reumatismo. 2026 Mar 16; 78 (1). DOI: 10.4081/reumatismo.2025.1865Antoniou KM, Distler O, Gheorghiu AM. et al. ERS/EULAR clinical practice guidelines for connective tissue disease-associated interstitial lung disease developed by the task force for connective tissue disease-associated interstitial lung disease of the European Respiratory Society (ERS) and the European Alliance of Associations for Rheumatology (EULAR) Endorsed by the European Reference Network on rare respiratory diseases (ERN-LUNG). Ann Rheum Dis. 2026; 85 (1): 22–60. DOI: 10.1016/j.ard.2025.08.021Antoniou KM, Distler O, Gheorghiu AM. et al. ERS/EULAR clinical practice guidelines for connective tissue disease-associated interstitial lung disease developed by the task force for connective tissue disease-associated interstitial lung disease of the European Respiratory Society (ERS) and the European Alliance of Associations for Rheumatology (EULAR) Endorsed by the European Reference Network on rare respiratory diseases (ERN-LUNG). Ann Rheum Dis. 2026; 85 (1): 22–60. DOI: 10.1016/j.ard.2025.08.021Luppi F, Manfredi A, Faverio P. et al. The usual Interstitial pneumonia pattern in autoimmune rheumatic diseases. BMC Pulm Med. 2023; 23 (1): 501. DOI: 10.1186/s12890-023-02783-zLuppi F, Manfredi A, Faverio P. et al. The usual Interstitial pneumonia pattern in autoimmune rheumatic diseases. BMC Pulm Med. 2023; 23 (1): 501. DOI: 10.1186/s12890-023-02783-zSong YJ, Kim H, Cho SK. et al. Risk factors of mortality in patients with rheumatoid arthritis-associated interstitial lung disease: a single-centre prospective cohort study. Arthritis Res Ther. 2024; 26 (1): 137. DOI: 10.1186/s13075-024-03362-1Song YJ, Kim H, Cho SK. et al. Risk factors of mortality in patients with rheumatoid arthritis-associated interstitial lung disease: a single-centre prospective cohort study. Arthritis Res Ther. 2024; 26 (1): 137. DOI: 10.1186/s13075-024-03362-1Cano-Jiménez E, Vázquez Rodríguez T, Martín-Robles I, et al.. Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis. Sci Rep. 2021; 11 (1): 9184. DOI: 10.1038/s41598-021-88734-2Cano-Jiménez E, Vázquez Rodríguez T, Martín-Robles I, et al.. Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis. Sci Rep. 2021; 11 (1): 9184. DOI: 10.1038/s41598-021-88734-2Smolen JS, Edwards CJ, Konzett V. et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update. Ann Rheum Dis. 2026 Mar 12: S 0003–4967 (26) 00075-0. DOI: 10.1016/j.ard.2026.01.023Smolen JS, Edwards CJ, Konzett V. et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biologic disease-modifying antirheumatic drugs: 2025 update. Ann Rheum Dis. 2026 Mar 12: S 0003–4967 (26) 00075-0. DOI: 10.1016/j.ard.2026.01.023Cassone G, Manfredi A, Vacchi C. et al. Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Lights and Shadows. J Clin Med. 2020; 9 (4): 1082. DOI: 10.3390/jcm9041082Cassone G, Manfredi A, Vacchi C. et al. Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease: Lights and Shadows. J Clin Med. 2020; 9 (4): 1082. DOI: 10.3390/jcm9041082Cartlidge MK, Brown KK, Chaudhuri N. et al. A modified Delphi exercise in physician-perceived risk factors for drug-induced pneumotoxicity in patients with rheumatological disease. BMC Pulm Med. 2024 Oct 31; 24 (1): 547. DOI: 10.1186/s12890-024-03287-0Cartlidge MK, Brown KK, Chaudhuri N. et al. A modified Delphi exercise in physician-perceived risk factors for drug-induced pneumotoxicity in patients with rheumatological disease. BMC Pulm Med. 2024 Oct 31; 24 (1): 547. DOI: 10.1186/s12890-024-03287-0Lewandowska AA, Waśniowska D, Rybacki C. et al. Pulmonary Complications in Connective Tissue Disease-Associated Interstitial Lung Disease. Clin Respir J. 2025; 19 (8): e70116. DOI: 10.1111/crj.70116Lewandowska AA, Waśniowska D, Rybacki C. et al. Pulmonary Complications in Connective Tissue Disease-Associated Interstitial Lung Disease. Clin Respir J. 2025; 19 (8): e70116. DOI: 10.1111/crj.70116Manfredi A, Cassone G, Luppi F. et al. Rheumatoid arthritis related interstitial lung disease. Expert Rev Clin Immunol. 2021; 17 (5): 485–497. DOI: 10.1080/1744666X.2021.1905524Manfredi A, Cassone G, Luppi F. et al. Rheumatoid arthritis related interstitial lung disease. Expert Rev Clin Immunol. 2021; 17 (5): 485–497. DOI: 10.1080/1744666X.2021.1905524Wells A, Devaraj A, Renzoni EA, Denton CP. Multidisciplinary Evaluation in Patients with Lung Disease Associated with Connective Tissue Disease. Semin Respir Crit Care Med. 2019; 40 (2): 184–193. DOI: 10.1055/s-0039-1684020Wells A, Devaraj A, Renzoni EA, Denton CP. Multidisciplinary Evaluation in Patients with Lung Disease Associated with Connective Tissue Disease. Semin Respir Crit Care Med. 2019; 40 (2): 184–193. DOI: 10.1055/s-0039-1684020Narváez J, Díaz Del Campo Fontecha P, Nieto MA. et al. Treatment of rheumatoid arthritis-associated interstitial lung disease: What is new since the 2022 SER-SEPAR recommendations? Reumatol Clin (Engl Ed). 2026: 502104. DOI: 10.1016/j.reumae.2026.502104Narváez J, Díaz Del Campo Fontecha P, Nieto MA. et al. Treatment of rheumatoid arthritis-associated interstitial lung disease: What is new since the 2022 SER-SEPAR recommendations? Reumatol Clin (Engl Ed). 2026: 502104. DOI: 10.1016/j.reumae.2026.502104Vacchi C, Sebastiani M, Cassone G. et al. Therapeutic Options for the Treatment of Interstitial Lung Disease Related to Connective Tissue Diseases. A Narrative Review. J Clin Med. 2020; 9 (2): 407. DOI: 10.3390/jcm9020407Vacchi C, Sebastiani M, Cassone G. et al. Therapeutic Options for the Treatment of Interstitial Lung Disease Related to Connective Tissue Diseases. A Narrative Review. J Clin Med. 2020; 9 (2): 407. DOI: 10.3390/jcm9020407Hyldgaard C, Pedersen AR, Ellingsen T, Bendstrup E. Pulmonary function trajectories in rheumatoid arthritis-associated interstitial lung disease. Scand J Rheumatol. 2025; 54 (5): 339–345. DOI: 10.1080/03009742.2025.2503054Hyldgaard C, Pedersen AR, Ellingsen T, Bendstrup E. Pulmonary function trajectories in rheumatoid arthritis-associated interstitial lung disease. Scand J Rheumatol. 2025; 54 (5): 339–345. DOI: 10.1080/03009742.2025.2503054Cottin V, Bendstrup E, Bonniaud P. et al. The case of methotrexate and the lung: Dr Jekyll and Mr Hyde. Eur Respir J. 2021; 57 (2): 2100079. DOI: 10.1183/13993003.00079-2021Cottin V, Bendstrup E, Bonniaud P. et al. The case of methotrexate and the lung: Dr Jekyll and Mr Hyde. Eur Respir J. 2021; 57 (2): 2100079. DOI: 10.1183/13993003.00079-2021Park E, Iqbal R, Giles JT, Bernstein EJ. Use of methotrexate and TNF inhibitors in patients with rheumatoid arthritis-associated interstitial lung disease: a survey of rheumatologists. Clin Rheumatol. 2024; 43 (9): 3029–3032. DOI: 10.1007/s10067-024-07068-2Park E, Iqbal R, Giles JT, Bernstein EJ. Use of methotrexate and TNF inhibitors in patients with rheumatoid arthritis-associated interstitial lung disease: a survey of rheumatologists. Clin Rheumatol. 2024; 43 (9): 3029–3032. DOI: 10.1007/s10067-024-07068-2Conway R, Low C, Coughlan RJ. et al. Methotrexate and lung disease in rheumatoid arthritis: a meta-analysis of randomized controlled trials. Arthritis Rheumatol. 2014 Apr; 66 (4): 803–12. DOI: 10.1002/art.38322Conway R, Low C, Coughlan RJ. et al. Methotrexate and lung disease in rheumatoid arthritis: a meta-analysis of randomized controlled trials. Arthritis Rheumatol. 2014 Apr; 66 (4): 803–12. DOI: 10.1002/art.38322Fragoulis GE, Conway R, Nikiphorou E. Methotrexate and interstitial lung disease: controversies and questions. A narrative review of the literature. Rheumatology (Oxford). 2019 Nov 1; 58 (11): 1900–1906. DOI: 10.1093/rheumatology/kez337Fragoulis GE, Conway R, Nikiphorou E. Methotrexate and interstitial lung disease: controversies and questions. A narrative review of the literature. Rheumatology (Oxford). 2019 Nov 1; 58 (11): 1900–1906. DOI: 10.1093/rheumatology/kez337Solomon DH, Glynn RJ, Karlson EW. et al. Adverse Effects of Low-Dose Methotrexate: A Randomized Trial. Ann Intern Med. 2020; 172 (6): 369–380. DOI: 10.7326/M19-3369Solomon DH, Glynn RJ, Karlson EW. et al. Adverse Effects of Low-Dose Methotrexate: A Randomized Trial. Ann Intern Med. 2020; 172 (6): 369–380. DOI: 10.7326/M19-3369Rojas-Serrano J, Herrera-Bringas D, Pérez-Román DI. et al. Rheumatoid arthritis-related interstitial lung disease (RA-ILD): methotrexate and the severity of lung disease are associated to prognosis. Clin Rheumatol. 201l; 36 (7): 1493–1500. DOI: 10.1007/s10067-017-3707-5Rojas-Serrano J, Herrera-Bringas D, Pérez-Román DI. et al. Rheumatoid arthritis-related interstitial lung disease (RA-ILD): methotrexate and the severity of lung disease are associated to prognosis. Clin Rheumatol. 201l; 36 (7): 1493–1500. DOI: 10.1007/s10067-017-3707-5Juge PA, Lee JS, Lau J. et al. Methotrexate and rheumatoid arthritis associated interstitial lung disease. Eur Respir J. 2021; 57 (2): 2000337. DOI: 10.1183/13993003.00337-2020Juge PA, Lee JS, Lau J. et al. Methotrexate and rheumatoid arthritis associated interstitial lung disease. Eur Respir J. 2021; 57 (2): 2000337. DOI: 10.1183/13993003.00337-2020Ibfelt EH, Jacobsen RK, Kopp TI. et al. Methotrexate and risk of interstitial lung disease and respiratory failure in rheumatoid arthritis: a nationwide population-based study. Rheumatology (Oxford). 2021; 60 (1): 346–352. DOI: 10.1093/rheumatology/keaa327Ibfelt EH, Jacobsen RK, Kopp TI. et al. Methotrexate and risk of interstitial lung disease and respiratory failure in rheumatoid arthritis: a nationwide population-based study. Rheumatology (Oxford). 2021; 60 (1): 346–352. DOI: 10.1093/rheumatology/keaa327Fraenkel L, Bathon JM, England BR. et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2021; 73 (7): 1108–1123. DOI: 10.1002/art.41752Fraenkel L, Bathon JM, England BR. et al. 2021 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol. 2021; 73 (7): 1108–1123. DOI: 10.1002/art.41752Zhang Q, McDermott GC, Juge PA. et al. Disease-modifying antirheumatic drugs and risk of incident interstitial lung disease among patients with rheumatoid arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2024; 69: 152561. DOI: 10.1016/j.semarthrit.2024.152561Zhang Q, McDermott GC, Juge PA. et al. Disease-modifying antirheumatic drugs and risk of incident interstitial lung disease among patients with rheumatoid arthritis: A systematic review and meta-analysis. Semin Arthritis Rheum. 2024; 69: 152561. DOI: 10.1016/j.semarthrit.2024.152561Miyazaki Y, Araki K, Vesin C. et al. Expression of a tumor necrosis factor-alpha transgene in murine lung causes lymphocytic and fibrosing alveolitis. A mouse model of progressive pulmonary fibrosis. J Clin Invest. 1995; 96 (1): 250–9. DOI: 10.1172/JCI118029Miyazaki Y, Araki K, Vesin C. et al. Expression of a tumor necrosis factor-alpha transgene in murine lung causes lymphocytic and fibrosing alveolitis. A mouse model of progressive pulmonary fibrosis. J Clin Invest. 1995; 96 (1): 250–9. DOI: 10.1172/JCI118029Sueoka N, Sueoka E, Miyazaki Y. et al. Molecular pathogenesis of interstitial pneumonitis with TNF-alpha transgenic mice. Cytokine. 1998; 10 (2): 124–31. DOI: 10.1006/cyto.1997.0267Sueoka N, Sueoka E, Miyazaki Y. et al. Molecular pathogenesis of interstitial pneumonitis with TNF-alpha transgenic mice. Cytokine. 1998; 10 (2): 124–31. DOI: 10.1006/cyto.1997.0267Perez-Alvarez R, Perez-de-Lis M, Diaz-Lagares C. et al. Interstitial lung disease induced or exacerbated by TNF-targeted therapies: analysis of 122 cases. Semin Arthritis Rheum. 2011; 41 (2): 256–64. DOI: 10.1016/j.semarthrit.2010.11.002Perez-Alvarez R, Perez-de-Lis M, Diaz-Lagares C. et al. Interstitial lung disease induced or exacerbated by TNF-targeted therapies: analysis of 122 cases. Semin Arthritis Rheum. 2011; 41 (2): 256–64. DOI: 10.1016/j.semarthrit.2010.11.002Curtis JR, Sarsour K, Napalkov P. et al. Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor α agents, a retrospective cohort study. Arthritis Res Ther. 2015;17:319. DOI: 10.1186/s13075-015-0835-7Curtis JR, Sarsour K, Napalkov P. et al. Incidence and complications of interstitial lung disease in users of tocilizumab, rituximab, abatacept and anti-tumor necrosis factor α agents, a retrospective cohort study. Arthritis Res Ther. 2015;17:319. DOI: 10.1186/s13075-015-0835-7Druce KL, Iqbal K, Watson KD. et al. Mortality in patients with interstitial lung disease treated with rituximab or TNFi as a first biologic. RMD Open. 2017; 3 (1): e000473. DOI: 10.1136/rmdopen-2017-000473Druce KL, Iqbal K, Watson KD. et al. Mortality in patients with interstitial lung disease treated with rituximab or TNFi as a first biologic. RMD Open. 2017; 3 (1): e000473. DOI: 10.1136/rmdopen-2017-000473Fassio A, Sebastiani M, Pollastri F et al. Updated systematic literature review and me ta-analysis to inform the Italian Society of Rheumatology Recommendations on the treatment of rheumatoid arthritis-associated interstitial lung disease. Autoimmun Rev. 2025; 24 (12): 103922. DOI: 10.1016/j.autrev.2025.103922Fassio A, Sebastiani M, Pollastri F et al. Updated systematic literature review and me ta-analysis to inform the Italian Society of Rheumatology Recommendations on the treatment of rheumatoid arthritis-associated interstitial lung disease. Autoimmun Rev. 2025; 24 (12): 103922. DOI: 10.1016/j.autrev.2025.103922Yuan H, Cui S, Yang L. et al. Efficacy of non-conventional synthetic DMARDs for patients with rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis. RMD Open. 2023; 9 (4): e003487. DOI: 10.1136/rmdopen-2023-003487Yuan H, Cui S, Yang L. et al. Efficacy of non-conventional synthetic DMARDs for patients with rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis. RMD Open. 2023; 9 (4): e003487. DOI: 10.1136/rmdopen-2023-003487Frideres H, Wichman CS, Dong J. et al. Non-TNFi biologic and targeted synthetic DMARDs in rheumatoid arthritis-associated interstitial lung disease: A propensity score matched, active-comparator, new-user study. Semin Arthritis Rheum. 2025; 73: 152735. DOI: 10.1016/j.semarthrit.2025.152735Frideres H, Wichman CS, Dong J. et al. Non-TNFi biologic and targeted synthetic DMARDs in rheumatoid arthritis-associated interstitial lung disease: A propensity score matched, active-comparator, new-user study. Semin Arthritis Rheum. 2025; 73: 152735. DOI: 10.1016/j.semarthrit.2025.152735Boleto G, Guignabert C, Pezet Set al. T-cell costimulation blockade is effective in experimental digestive and lung tissue fibrosis. Arthritis Res Ther. 2018; 20 (1): 197. DOI: 10.1186/s13075-018-1694-9Boleto G, Guignabert C, Pezet Set al. T-cell costimulation blockade is effective in experimental digestive and lung tissue fibrosis. Arthritis Res Ther. 2018; 20 (1): 197. DOI: 10.1186/s13075-018-1694-9Jiménez-Alvarez L, Arreola JL, Ramírez-Martínez G. et al. The effect of CTLA-4Ig, a CD 28/B 7 antagonist, on the lung inflammation and T cell subset profile during murine hypersensitivity pneumonitis. Exp Mol Pathol. 2011; 91 (3): 718–22. DOI: 10.1016/j.yexmp.2011.09.010Jiménez-Alvarez L, Arreola JL, Ramírez-Martínez G. et al. The effect of CTLA-4Ig, a CD 28/B 7 antagonist, on the lung inflammation and T cell subset profile during murine hypersensitivity pneumonitis. Exp Mol Pathol. 2011; 91 (3): 718–22. DOI: 10.1016/j.yexmp.2011.09.010Fernández-Díaz C, Atienza-Mateo B, Castañeda S. et al. Abatacept in monotherapy vs combined in interstitial lung disease of rheumatoid arthritis-multicentre study of 263 Caucasian patients. Rheumatology (Oxford). 2021; 61 (1): 299–308. DOI: 10.1093/rheumatology/keab317Fernández-Díaz C, Atienza-Mateo B, Castañeda S. et al. Abatacept in monotherapy vs combined in interstitial lung disease of rheumatoid arthritis-multicentre study of 263 Caucasian patients. Rheumatology (Oxford). 2021; 61 (1): 299–308. DOI: 10.1093/rheumatology/keab317Cassone G, Manfredi A, Atzeni F. et al. Safety of Abatacept in Italian Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Multicenter Retrospective Study. J Clin Med. 2020; 9 (1): 277. DOI: 10.3390/jcm9010277Cassone G, Manfredi A, Atzeni F. et al. Safety of Abatacept in Italian Patients with Rheumatoid Arthritis and Interstitial Lung Disease: A Multicenter Retrospective Study. J Clin Med. 2020; 9 (1): 277. DOI: 10.3390/jcm9010277Shih PC, Wang SI, Wei JCC. Association of Abatacept With Lower Mortality Risk Compared to Rituximab in Rheumatoid Arthritis-Associated Interstitial Lung Disease: An Emulated Target Trial. Arthritis Rheumatol. 2026; 78 (3): 592–602. DOI: 10.1002/art.43332Shih PC, Wang SI, Wei JCC. Association of Abatacept With Lower Mortality Risk Compared to Rituximab in Rheumatoid Arthritis-Associated Interstitial Lung Disease: An Emulated Target Trial. Arthritis Rheumatol. 2026; 78 (3): 592–602. DOI: 10.1002/art.43332Vicente-Rabaneda EF, Atienza-Mateo B, Blanco R. et al. Efficacy and safety of abatacept in interstitial lung disease of rheumatoid arthritis: A systematic literature review. Autoimmun Rev. 2021; 20 (6): 102830. DOI: 10.1016/j.autrev.2021.102830Vicente-Rabaneda EF, Atienza-Mateo B, Blanco R. et al. Efficacy and safety of abatacept in interstitial lung disease of rheumatoid arthritis: A systematic literature review. Autoimmun Rev. 2021; 20 (6): 102830. DOI: 10.1016/j.autrev.2021.102830Matson SM, Baqir M, Moua T. et al. Treatment Outcomes for Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Real-World, Multisite Study of the Impact of Immunosuppression on Pulmonary Function Trajectory. Chest. 2023; 163 (4): 861–869. DOI: 10.1016/j.chest.2022.11.035Matson SM, Baqir M, Moua T. et al. Treatment Outcomes for Rheumatoid Arthritis-Associated Interstitial Lung Disease: A Real-World, Multisite Study of the Impact of Immunosuppression on Pulmonary Function Trajectory. Chest. 2023; 163 (4): 861–869. DOI: 10.1016/j.chest.2022.11.035Vadillo C, Nieto MA, Romero-Bueno F. et al.Efficacy of rituximab in slowing down progression of rheumatoid arthritis-related interstitial lung disease: data from the NEREA Registry. Rheumatology (Oxford). 2020; 59 (8): 2099–2108. DOI: 10.1093/rheumatology/kez673Vadillo C, Nieto MA, Romero-Bueno F. et al.Efficacy of rituximab in slowing down progression of rheumatoid arthritis-related interstitial lung disease: data from the NEREA Registry. Rheumatology (Oxford). 2020; 59 (8): 2099–2108. DOI: 10.1093/rheumatology/kez673Vacchi C, Manfredi A, Cassone G. et al. Efficacy and safety of rituximab in the treatment of connective tissue disease-related interstitial lung disease. Drugs Context. 2021; 10: 2020-8-7. DOI: 10.7573/dic.2020-8-7Vacchi C, Manfredi A, Cassone G. et al. Efficacy and safety of rituximab in the treatment of connective tissue disease-related interstitial lung disease. Drugs Context. 2021; 10: 2020-8-7. DOI: 10.7573/dic.2020-8-7Atienza-Mateo B, Remuzgo-Martínez S, Prieto-Peña D. et al. Rituximab in the Treatment of Interstitial Lung Disease Associated with Autoimmune Diseases: Experience from a Single Referral Center and Literature Review. J Clin Med. 2020; 9 (10): 3070. DOI: 10.3390/jcm9103070Atienza-Mateo B, Remuzgo-Martínez S, Prieto-Peña D. et al. Rituximab in the Treatment of Interstitial Lung Disease Associated with Autoimmune Diseases: Experience from a Single Referral Center and Literature Review. J Clin Med. 2020; 9 (10): 3070. DOI: 10.3390/jcm9103070Khandpur R, Carmona-Rivera C, Vivekanandan-Giri A. et al. NETs are a source of citrullinated autoantigens and stimulate inflammatory responses in rheumatoid arthritis. Sci Transl Med. 2013; 5 (178): 178ra40. DOI: 10.1126/scitranslmed.3005580Khandpur R, Carmona-Rivera C, Vivekanandan-Giri A. et al. NETs are a source of citrullinated autoantigens and stimulate inflammatory responses in rheumatoid arthritis. Sci Transl Med. 2013; 5 (178): 178ra40. DOI: 10.1126/scitranslmed.3005580Numajiri H, Kuzumi A, Fukasawa T. et al. B Cell Depletion Inhibits Fibrosis via Suppression of Profibrotic Macrophage Differentiation in a Mouse Model of Systemic Sclerosis. Arthritis Rheumatol. 2021; 73 (11): 2086–2095. DOI: 10.1002/art.41798Numajiri H, Kuzumi A, Fukasawa T. et al. B Cell Depletion Inhibits Fibrosis via Suppression of Profibrotic Macrophage Differentiation in a Mouse Model of Systemic Sclerosis. Arthritis Rheumatol. 2021; 73 (11): 2086–2095. DOI: 10.1002/art.41798Krishna Boppana T, Mittal S, Madan K. et al. Rituximab for rheumatoid arthritis-related interstitial lung disease: A systematic review and meta-analysis. Arch Rheumatol. 2024; 39 (2): 317–329. DOI: 10.46497/ArchRheumatol.2024.10199Krishna Boppana T, Mittal S, Madan K. et al. Rituximab for rheumatoid arthritis-related interstitial lung disease: A systematic review and meta-analysis. Arch Rheumatol. 2024; 39 (2): 317–329. DOI: 10.46497/ArchRheumatol.2024.10199Kelly CA, Nisar M, Arthanari S. et al. Rheumatoid arthritis related interstitial lung disease – improving outcomes over 25 years: a large multicentre UK study. Rheumatology (Oxford). 2021; 60 (4): 1882–1890. DOI: 10.1093/rheumatology/keaa577Kelly CA, Nisar M, Arthanari S. et al. Rheumatoid arthritis related interstitial lung disease – improving outcomes over 25 years: a large multicentre UK study. Rheumatology (Oxford). 2021; 60 (4): 1882–1890. DOI: 10.1093/rheumatology/keaa577Narváez J, Robles-Pérez A, Molina-Molina M. et al. Real-world clinical effectiveness of rituximab rescue therapy in patients with progressive rheumatoid arthritis-related interstitial lung disease. Semin Arthritis Rheum. 2020; 50 (5): 902–910. DOI: 10.1016/j.semarthrit.2020.08.008Narváez J, Robles-Pérez A, Molina-Molina M. et al. Real-world clinical effectiveness of rituximab rescue therapy in patients with progressive rheumatoid arthritis-related interstitial lung disease. Semin Arthritis Rheum. 2020; 50 (5): 902–910. DOI: 10.1016/j.semarthrit.2020.08.008Md Yusof MY, Kabia A, Darby M. et al. Effect of rituximab on the progression of rheumatoid arthritis-related interstitial lung disease: 10 years' experience at a single centre. Rheumatology (Oxford). 2017; 56 (8): 1348–1357. DOI: 10.1093/rheumatology/kex072Md Yusof MY, Kabia A, Darby M. et al. Effect of rituximab on the progression of rheumatoid arthritis-related interstitial lung disease: 10 years' experience at a single centre. Rheumatology (Oxford). 2017; 56 (8): 1348–1357. DOI: 10.1093/rheumatology/kex072Bousoik E, Montazeri Aliabadi H. «Do We Know Jack» About JAK? A Closer Look at JAK/STAT Signaling Pathway. Front Oncol. 2018; 8: 287. DOI: 10.3389/fonc.2018.00287Bousoik E, Montazeri Aliabadi H. «Do We Know Jack» About JAK? A Closer Look at JAK/STAT Signaling Pathway. Front Oncol. 2018; 8: 287. DOI: 10.3389/fonc.2018.00287Ma X, Chen R, Liu X. et al. Effects of matrineon JAK-STAT signaling transduction pathways in bleomycin-induced pulmonary fibrosis. Afr J Tradit Complement Altern Med. 2013; 10 (3): 442–8. DOI: 10.4314/ajtcam.v10i3.10Ma X, Chen R, Liu X. et al. Effects of matrineon JAK-STAT signaling transduction pathways in bleomycin-induced pulmonary fibrosis. Afr J Tradit Complement Altern Med. 2013; 10 (3): 442–8. DOI: 10.4314/ajtcam.v10i3.10Milara J, Hernandez G, Ballester B. et al. The JAK2 pathway is activated in idiopathic pulmonary fibrosis. Respir Res. 2018; 19 (1): 24. DOI: 10.1186/s12931-018-0728-9Milara J, Hernandez G, Ballester B. et al. The JAK2 pathway is activated in idiopathic pulmonary fibrosis. Respir Res. 2018; 19 (1): 24. DOI: 10.1186/s12931-018-0728-9Wang S, Liu M, Li X. et al. Canonical and noncanonical regulatory roles for JAK2 in the pathogenesis of rheumatoid arthritis-associated interstitial lung disease and idiopathic pulmonary fibrosis. FASEB J. 2022; 36 (6): e22336. DOI: 10.1096/fj.202101436RWang S, Liu M, Li X. et al. Canonical and noncanonical regulatory roles for JAK2 in the pathogenesis of rheumatoid arthritis-associated interstitial lung disease and idiopathic pulmonary fibrosis. FASEB J. 2022; 36 (6): e22336. DOI: 10.1096/fj.202101436RSebastiani M, Manfredi A, Croci S. et al. Rheumatoid arthritis extra-articular lung disease: new insights on pathogenesis and experimental drugs. Expert Opin Investig Drugs. 2024; 33 (8): 815–827. DOI: 10.1080/13543784.2024.2376567Sebastiani M, Manfredi A, Croci S. et al. Rheumatoid arthritis extra-articular lung disease: new insights on pathogenesis and experimental drugs. Expert Opin Investig Drugs. 2024; 33 (8): 815–827. DOI: 10.1080/13543784.2024.2376567Liu Y, Hu M, Fan G. et al. Effect of Baricitinib on the epithelial-mesenchymal transition of alveolar epithelial cells induced by IL-6. Int Immunopharmacol. 2022; 110: 109044. DOI: 10.1016/j.intimp.2022.109044Liu Y, Hu M, Fan G. et al. Effect of Baricitinib on the epithelial-mesenchymal transition of alveolar epithelial cells induced by IL-6. Int Immunopharmacol. 2022; 110: 109044. DOI: 10.1016/j.intimp.2022.109044Venerito V, Manfredi A, Carletto A. et al. Evolution of Rheumatoid-Arthritis-Associated Interstitial Lung Disease in Patients Treated with JAK Inhibitors: A Retrospective Exploratory Study. J Clin Med. 2023; 12 (3): 957. DOI: 10.3390/jcm12030957Venerito V, Manfredi A, Carletto A. et al. Evolution of Rheumatoid-Arthritis-Associated Interstitial Lung Disease in Patients Treated with JAK Inhibitors: A Retrospective Exploratory Study. J Clin Med. 2023; 12 (3): 957. DOI: 10.3390/jcm12030957Tardella M, Di Carlo M, Carotti M. et al. A retrospective study of the efficacy of JAK inhibitors or abatacept on rheumatoid arthritis-interstitial lung disease. Inflammopharmacology. 2022; 30 (3): 705–712. DOI: 10.1007/s10787-022-00936-wTardella M, Di Carlo M, Carotti M. et al. A retrospective study of the efficacy of JAK inhibitors or abatacept on rheumatoid arthritis-interstitial lung disease. Inflammopharmacology. 2022; 30 (3): 705–712. DOI: 10.1007/s10787-022-00936-wSerrano-Combarro A, Atienza-Mateo B, Martín-Gutiérrez A. et al. Baricitinib in rheumatoid arthritis-interstitial lung disease: a literature review and national multicentre study of 72 patients. Rheumatology (Oxford). 2025; 64 (10): 5471–5480. DOI: 10.1093/rheumatology/keaf314Serrano-Combarro A, Atienza-Mateo B, Martín-Gutiérrez A. et al. Baricitinib in rheumatoid arthritis-interstitial lung disease: a literature review and national multicentre study of 72 patients. Rheumatology (Oxford). 2025; 64 (10): 5471–5480. DOI: 10.1093/rheumatology/keaf314Mochizuki T, Yano K, Ikari K, Okazaki K. Radiological evaluation of interstitial lung disease in patients with rheumatoid arthritis treated with abatacept or JAK inhibitors for 1 year. Respir Investig. 2023; 61 (3): 359–363. DOI: 10.1016/j.resinv.2023.02.007Mochizuki T, Yano K, Ikari K, Okazaki K. Radiological evaluation of interstitial lung disease in patients with rheumatoid arthritis treated with abatacept or JAK inhibitors for 1 year. Respir Investig. 2023; 61 (3): 359–363. DOI: 10.1016/j.resinv.2023.02.007Narváez J, Aguilar-Coll M, Roig-Kim M. et al. Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: A systematic review and meta-analysis. Autoimmun Rev. 2024; 23 (10): 103636. DOI: 10.1016/j.autrev.2024.103636Narváez J, Aguilar-Coll M, Roig-Kim M. et al. Janus kinase inhibitors in rheumatoid arthritis-associated interstitial lung disease: A systematic review and meta-analysis. Autoimmun Rev. 2024; 23 (10): 103636. DOI: 10.1016/j.autrev.2024.103636Nishii Y, Okamoto M, Zaizen Y. et al. Successful Treatment of a Patient with Drug-Refractory Rheumatoid Arthritis-Associated Interstitial Lung Disease with Upadacitinib: A Case Report. Medicina (Kaunas). 2023; 59 (11): 1960. DOI: 10.3390/medicina59111960Nishii Y, Okamoto M, Zaizen Y. et al. Successful Treatment of a Patient with Drug-Refractory Rheumatoid Arthritis-Associated Interstitial Lung Disease with Upadacitinib: A Case Report. Medicina (Kaunas). 2023; 59 (11): 1960. DOI: 10.3390/medicina59111960Lv Y, Zhang G, Kong D, Jiang W. Filgotinib Improves Experimental Pulmonary Fibrosis by Modulating JAK1/STAT3/SOCS 3/IL-17A Signalling. Basic Clin Pharmacol Toxicol. 2025; 136 (4): e70012. DOI: 10.1111/bcpt.70012Lv Y, Zhang G, Kong D, Jiang W. Filgotinib Improves Experimental Pulmonary Fibrosis by Modulating JAK1/STAT3/SOCS 3/IL-17A Signalling. Basic Clin Pharmacol Toxicol. 2025; 136 (4): e70012. DOI: 10.1111/bcpt.70012Sunaga A, Inoue T. Successful treatment of rheumatoid arthritis-associated interstitial lung disease with filgotinib: A case report on janus kinase 1 inhibition. Respirol Case Rep. 2024; 12 (9): e70023. DOI: 10.1002/rcr2.70023Sunaga A, Inoue T. Successful treatment of rheumatoid arthritis-associated interstitial lung disease with filgotinib: A case report on janus kinase 1 inhibition. Respirol Case Rep. 2024; 12 (9): e70023. DOI: 10.1002/rcr2.70023Ytterberg SR, Bhatt DL, Mikuls T. et al. Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis. N Engl J Med. 2022; 386 (4): 316–326. DOI: 10.1056/NEJMoa2109927Ytterberg SR, Bhatt DL, Mikuls T. et al. Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis. N Engl J Med. 2022; 386 (4): 316–326. DOI: 10.1056/NEJMoa2109927Shih PC, Zou QH, Lai CC. et al. Mortality and medical utilization in rheumatoid arthritis associated interstitial lung disease: A real-world, large-scale retrospective study com paring Janus kinase inhibitors and tumor necrosis factor inhibitors. Semin Arthritis Rheum. 2025; 71: 152636. DOI: 10.1016/j.semarthrit.2025.152636Shih PC, Zou QH, Lai CC. et al. Mortality and medical utilization in rheumatoid arthritis associated interstitial lung disease: A real-world, large-scale retrospective study com paring Janus kinase inhibitors and tumor necrosis factor inhibitors. Semin Arthritis Rheum. 2025; 71: 152636. DOI: 10.1016/j.semarthrit.2025.152636Suzuki K, Akiyama M, Kaneko Y. Long-term efficacy of sarilumab on the progression of interstitial lung disease in rheumatoid arthritis: the KEIO-RA cohort and literature review. Clin Exp Rheumatol. 2025; 43 (3): 451–458. DOI: 10.55563/clinexprheumatol/pc2kq1Suzuki K, Akiyama M, Kaneko Y. Long-term efficacy of sarilumab on the progression of interstitial lung disease in rheumatoid arthritis: the KEIO-RA cohort and literature review. Clin Exp Rheumatol. 2025; 43 (3): 451–458. DOI: 10.55563/clinexprheumatol/pc2kq1Otsuji N, Sugiyama K, Owada T. et al. Safety of Tocilizumab on Rheumatoid Arthritis in Patients with Interstitial Lung Disease. Open Access Rheumatol. 2024; 16: 127–135. DOI: 10.2147/OARRR.S462662Otsuji N, Sugiyama K, Owada T. et al. Safety of Tocilizumab on Rheumatoid Arthritis in Patients with Interstitial Lung Disease. Open Access Rheumatol. 2024; 16: 127–135. DOI: 10.2147/OARRR.S462662Manfredi A, Cassone G, Furini F. et al. Tocilizumab therapy in rheumatoid arthritis with interstitial lung disease: a multicentre retrospective study. Intern Med J. 2020; 50 (9): 1085–1090. DOI: 10.1111/imj.14670Manfredi A, Cassone G, Furini F. et al. Tocilizumab therapy in rheumatoid arthritis with interstitial lung disease: a multicentre retrospective study. Intern Med J. 2020; 50 (9): 1085–1090. DOI: 10.1111/imj.14670Sebastiani M, Manfredi A, Cassone G. et al. Interstitial lung disease is associated to infections of lower respiratory tract in immunocompromised rheumatoid arthritis patients. Clin Exp Rheumatol. 2017; 35 (3): 542.Sebastiani M, Manfredi A, Cassone G. et al. Interstitial lung disease is associated to infections of lower respiratory tract in immunocompromised rheumatoid arthritis patients. Clin Exp Rheumatol. 2017; 35 (3): 542.Simon TA, Suissa S, Skovron ML. et al. Infection outcomes in patients with rheumatoid arthritis treated with abatacept and other disease-modifying antirheumatic drugs: Results from a 10-year international post-marketing study. Semin Arthritis Rheum. 2024; 64: 152313. DOI: 10.1016/j.semarthrit.2023.152313Simon TA, Suissa S, Skovron ML. et al. Infection outcomes in patients with rheumatoid arthritis treated with abatacept and other disease-modifying antirheumatic drugs: Results from a 10-year international post-marketing study. Semin Arthritis Rheum. 2024; 64: 152313. DOI: 10.1016/j.semarthrit.2023.152313Flaherty KR, Wells AU, Cottin V. et al. Nintedanib in Progressive Fibrosing Interstitial Lung Diseases. N Engl J Med. 2019; 381 (18): 1718–1727. DOI: 10.1056/NEJMoa1908681Flaherty KR, Wells AU, Cottin V. et al. Nintedanib in Progressive Fibrosing Interstitial Lung Diseases. N Engl J Med. 2019; 381 (18): 1718–1727. DOI: 10.1056/NEJMoa1908681Juge PA, Hayashi K, McDermott GC. et al. Effectiveness and tolerability of antifibrotics in rheumatoid arthritis-associated interstitial lung disease. Semin Arthritis Rheum. 2024; 64: 152312. DOI: 10.1016/j.semarthrit.2023.152312Juge PA, Hayashi K, McDermott GC. et al. Effectiveness and tolerability of antifibrotics in rheumatoid arthritis-associated interstitial lung disease. Semin Arthritis Rheum. 2024; 64: 152312. DOI: 10.1016/j.semarthrit.2023.152312Atienza-Mateo B, Serrano-Combarro A, Loarce Martos J. et al. Real-world evidence of the antifibrotic nintedanib in rheumatoid arthritis-interstitial lung disease. National multicenter study of 74 patients. Semin Arthritis Rheum. 2025; 72: 152710. DOI: 10.1016/j.semarthrit.2025.152710Atienza-Mateo B, Serrano-Combarro A, Loarce Martos J. et al. Real-world evidence of the antifibrotic nintedanib in rheumatoid arthritis-interstitial lung disease. National multicenter study of 74 patients. Semin Arthritis Rheum. 2025; 72: 152710. DOI: 10.1016/j.semarthrit.2025.152710Narváez J, Aguilar-Coll M, Roig-Kim M. et al. Efficacy, safety, and tolerability of antifibrotic agents in rheumatoid arthritis-associated interstitial lung disease: A systematic review and meta-analysis. Autoimmun Rev. 2025; 24 (6): 103804. DOI: 10.1016/j.autrev.2025.103804Narváez J, Aguilar-Coll M, Roig-Kim M. et al. Efficacy, safety, and tolerability of antifibrotic agents in rheumatoid arthritis-associated interstitial lung disease: A systematic review and meta-analysis. Autoimmun Rev. 2025; 24 (6): 103804. DOI: 10.1016/j.autrev.2025.103804Solomon JJ, Danoff SK, Woodhead FA. et al. Safety, tolerability, and efficacy of pirfenidone in patients with rheumatoid arthritis-associated interstitial lung disease: a randomised, double-blind, placebo-controlled, phase 2 study. Lancet Respir Med. 2023; 11 (1): 87–96. DOI: 10.1016/S2213-2600(22)00260-0Solomon JJ, Danoff SK, Woodhead FA. et al. Safety, tolerability, and efficacy of pirfenidone in patients with rheumatoid arthritis-associated interstitial lung disease: a randomised, double-blind, placebo-controlled, phase 2 study. Lancet Respir Med. 2023; 11 (1): 87–96. DOI: 10.1016/S2213-2600(22)00260-0Ревматоидный артрит. Клинические рекомендации РФ 2024. URL: https://diseases.medelement.com/disease/%D1%80%D0%B5%D0%B2%D0%BC%D0%B0%D1%82%D0%BE%D0%B8%D0%B4%D0%BD%D1%8B%D0%B9%D0%B0%D1%80%D1%82%D1%80%D0%B8%D1%82%D0%BA%D1%80%D1%80%D1%84–2024/18506?ysclid=mofm03t8zx688943843/ (дата обращения: 25.04.2026).Rheumatoid Arthritis. Clinical Guidelines of the Russian Federation 2024. URL: https://diseases.medelement.com/disease/%D1%80%D0%B5%D0%B2%D0%BC%D0%B0%D1%82%D0%BE%D0%B8%D0%B4%D0%BD%D1%8B%D0%B9%D0%B0%D1%80%D1%82%D1%80%D0%B8%D1%82%D0%BA%D1%80%D1%80%D1%84–2024/18506?ysclid=mofm03t8zx688943843/ (дата обращения: 25.04.2026).Sebastiani M, Lepri G, Iannone C. et al. Nintedanib in Rheumatoid Arthritis-Related Interstitial Lung Disease: Real-World Safety Profile and Risk of Side Effects and Discontinuation. J Rheumatol. 2025; 52 (5): 420–425. DOI: 10.3899/jrheum.2024-0976Sebastiani M, Lepri G, Iannone C. et al. Nintedanib in Rheumatoid Arthritis-Related Interstitial Lung Disease: Real-World Safety Profile and Risk of Side Effects and Discontinuation. J Rheumatol. 2025; 52 (5): 420–425. DOI: 10.3899/jrheum.2024-0976Maher TM, Assassi S, Azuma A. et al. Nerandomilast in Patients with Progressive Pul monary Fibrosis. N Engl J Med. 2025;392(22):2203–2214. DOI: 10.1056/NEJMoa2503643Maher TM, Assassi S, Azuma A. et al. Nerandomilast in Patients with Progressive Pul monary Fibrosis. N Engl J Med. 2025;392(22):2203–2214. DOI: 10.1056/NEJMoa2503643Richeldi L, Azuma A, Cottin V. et al. Nerandomilast in Patients with Idiopathic Pulmonary Fibrosis. N Engl J Med. 2025; 392 (22): 2193–2202. DOI: 10.1056/NEJMoa2414108Richeldi L, Azuma A, Cottin V. et al. Nerandomilast in Patients with Idiopathic Pulmonary Fibrosis. N Engl J Med. 2025; 392 (22): 2193–2202. DOI: 10.1056/NEJMoa2414108Reininger D, Fundel-Clemens K, Mayr CH. et al. PDE 4B inhibition by nerandomilast: Effects on lung fibrosis and transcriptome in fibrotic rats and on biomarkers in human lung epithelial cells. Br J Pharmacol. 2024; 181 (23): 4766–4781. DOI: 10.1111/bph.17303Reininger D, Fundel-Clemens K, Mayr CH. et al. PDE 4B inhibition by nerandomilast: Effects on lung fibrosis and transcriptome in fibrotic rats and on biomarkers in human lung epithelial cells. Br J Pharmacol. 2024; 181 (23): 4766–4781. DOI: 10.1111/bph.17303Luppi F, Sebastiani M, Salvarani C. et al. Acute exacerbation of interstitial lung disease associated with rheumatic disease. Nat Rev Rheumatol. 2022; 18 (2): 85–96. DOI: 10.1038/s41584-021-00721-zLuppi F, Sebastiani M, Salvarani C. et al. Acute exacerbation of interstitial lung disease associated with rheumatic disease. Nat Rev Rheumatol. 2022; 18 (2): 85–96. DOI: 10.1038/s41584-021-00721-zManfredi A, Sebastiani M, Cerri S. et al. Acute exacerbation of interstitial lung diseases secondary to systemic rheumatic diseases: a prospective study and review of the literature. J Thorac Dis. 2019; 11 (4): 1621–1628. DOI: 10.21037/jtd.2019.03.28Manfredi A, Sebastiani M, Cerri S. et al. Acute exacerbation of interstitial lung diseases secondary to systemic rheumatic diseases: a prospective study and review of the literature. J Thorac Dis. 2019; 11 (4): 1621–1628. DOI: 10.21037/jtd.2019.03.28Luppi F, Manfredi A, Faverio P. et al. Treatment of acute exacerbation in interstitial lung disease secondary to autoimmune rheumatic diseases: More questions than answers. Autoimmun Rev. 2024; 23 (12): 103668. DOI: 10.1016/j.autrev.2024.103668Luppi F, Manfredi A, Faverio P. et al. Treatment of acute exacerbation in interstitial lung disease secondary to autoimmune rheumatic diseases: More questions than answers. Autoimmun Rev. 2024; 23 (12): 103668. DOI: 10.1016/j.autrev.2024.103668Nakamura K, Ohbe H, Ikeda K. et al. Intravenous cyclophosphamide in acute exacerbation of rheumatoid arthritis-related interstitial lung disease: A propensity-matched analysis using a nationwide inpatient database. Semin Arthritis Rheum. 2021; 51 (5): 977–982. DOI: 10.1016/j.semarthrit.2021.07.008Nakamura K, Ohbe H, Ikeda K. et al. Intravenous cyclophosphamide in acute exacerbation of rheumatoid arthritis-related interstitial lung disease: A propensity-matched analysis using a nationwide inpatient database. Semin Arthritis Rheum. 2021; 51 (5): 977–982. DOI: 10.1016/j.semarthrit.2021.07.008León Román F, Pintado-Cort B, García-Casado D. et al. Rituximab for the treatment of acute exacerbation of interstitial lung disease associated with connective tissue disease. RMD Open. 2023; 9 (3): e003479. DOI: 10.1136/rmdopen-2023-003479.León Román F, Pintado-Cort B, García-Casado D. et al. Rituximab for the treatment of acute exacerbation of interstitial lung disease associated with connective tissue disease. RMD Open. 2023; 9 (3): e003479. DOI: 10.1136/rmdopen-2023-003479.Sebastiani M, Luppi F, Bendstrup E. Developments and Challenges in Treating Rheumatoid Arthritis-Related Interstitial Lung Disease: From Pathogenesis to Treatment Opportunities. Drugs. 2026; 86 (3): 287–299. DOI: 10.1007/s40265-025-02282-xSebastiani M, Luppi F, Bendstrup E. Developments and Challenges in Treating Rheumatoid Arthritis-Related Interstitial Lung Disease: From Pathogenesis to Treatment Opportunities. Drugs. 2026; 86 (3): 287–299. DOI: 10.1007/s40265-025-02282-x

The authors declare that there are no conflicts of interest present.