PO:08:217 Risk factors for interstitial lung disease in systemic lupus erythematosus: insights from the literature

Objectives To synthesize evidences on risk factors predisposing to interstitial lung disease (ILD) in systemic lupus erythematosus (SLE) and to propose a risk-stratified screening algorithm for clinical use.Methods We performed a narrative literature review using PubMed, EMBASE, and conference abstracts (up to October 2025), focusing on cohort, case–control, retrospective, and registry studies, as well as systematic reviews and meta-analyses addressing ILD in SLE. Key elements extracted included ILD definitions, prevalence estimates, independent risk factors, and outcomes. Due to heterogeneity across studies (geography, design, ILD criteria), results were summarized qualitatively and schematically.Results The pooled prevalence of ILD in SLE is approximately 6% (range 3–10%). In SLE-specific cohorts and case series, ILD is rare but clinically significant. Clinical and serologic risk factors include older age and longer disease duration (the strongest and most consistent predictors); Raynaud’s phenomenon, scleroderma-spectrum features, and myositis overlap; anti-SSA/Ro and anti-U1 RNP antibodies; high disease activity and high cumulative glucocorticoid exposure; and smoking or environmental factors (reported inconsistently). Patients with ILD have worse outcomes, including increased morbidity and mortality. Based on the synthesis of data, we propose a risk-stratified screening algorithm ( figure 1) in which SLE patients with several of the mentioned features are prioritized for baseline high-resolution computed tomography (HRCT) and full pulmonary function testing (PFT) including diffusing capacity for carbon monoxide (DLCO). For lower-risk patients, annual PFTs and imaging are recommended only if symptoms develop.Abstract PO:08:217 Figure 1Conclusions Although ILD is an uncommon manifestation of SLE, a reproducible cluster of risk factors has been identified. A targeted, risk-based screening strategy represents a logical approach pending consistent prospective studies and validation of predictive models.