Treatment trajectories by radiologic pattern of lung injury in interstitial lung disease with myositis-associated antibodies: a retrospective cohort study
Abstract
Objectives: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
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BibTeX
@article{grudzinski2026treatment,
title = {{Treatment trajectories by radiologic pattern of lung injury in interstitial lung disease with myositis-associated antibodies: a retrospective cohort study}},
author = {Kevin Grudzinski and Thomas C Bolig and Malek Shawabkeh and Kavitha C Selvan and Raymond J Goodwin and Emily Olson and Bradford C Bemiss and Nishant Parekh and Hatice Savas and Jane E Dematte and Anthony J Esposito},
journal = {Rheumatology Advances in Practice},
year = {2026},
month = oct,
doi = {10.1093/rap/rkag128},
url = {https://doi.org/10.1093/rap/rkag128},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Treatment trajectories by radiologic pattern of lung injury in interstitial lung disease with myositis-associated antibodies: a retrospective cohort study
AU - Kevin Grudzinski
AU - Thomas C Bolig
AU - Malek Shawabkeh
AU - Kavitha C Selvan
AU - Raymond J Goodwin
AU - Emily Olson
AU - Bradford C Bemiss
AU - Nishant Parekh
AU - Hatice Savas
AU - Jane E Dematte
AU - Anthony J Esposito
PY - 2026
DA - 2026/10/20
JO - Rheumatology Advances in Practice
DO - 10.1093/rap/rkag128
UR - https://doi.org/10.1093/rap/rkag128
AB - Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.
SN - 2514-1775
ER -