Document resource
Introduction To evaluate current treatment patterns for systemic sclerosis-associated interstitial lung disease (SSc-ILD) and identify factors influencing therapy initiation, switching, discontinuation, and combination strategies.Material and Methods SSc-ILD patients started on immunesuppresive and/or anti-fibrotic therapies from the EUSTAR database in the contemporary cohort (>=2017) were identified. Treatment regimens, including monotherapy, combination therapies, switchs and suspensions as well as factors influencing treatment decisions, were analyzed using multivariable logistic regression.Results Among 277 patients, 377 mycophenolate mofetil-based regimens, 186 methotrexate-based regimens, 257 rituximab-based regimens and 122 tocilizumab-based regimens were identified, see figure 1. 14% of regimens were switched from one drug to another and 24% were stopped. We identified that shorter disease duration was significantly associated with IST and antifibrotic therapy initiation at the first evaluation (OR 0.991, 95% CI 0.987–0.996, p <0.001). Additionally, the presence of concomitant myositis was strongly linked to IST and antifibrotic therapy initiation (OR 9.934, 95% CI 1.936-51.764, p = 0.006). The likelihood of switching treatments was significantly higher in patients with a higher mRSS (OR 1.031, 95% CI 1.002 – 1.062, p = 0.035) and in patients with arthritis (OR 3.034, 95% CI 1.551 – 5.936, p = 0.001). No clinical feature was found to be significantly associated with treatment discontinuation. Throughout the study period, the use of combination therapy was associated with younger age (OR 0.968, 95% CI 0.953 – 0.985, p <0.001), higher dyspnea class (OR 1.557, 95% CI 1.189 – 2.039, p = 0.001), and inflammatory arthritis (OR 2.560, 95% CI 1.354 – 4.840, p = 0.004).Conclusions In the contemporary cohort, MMF is the cornerstone of therapy, often used in combination (>50%). Clinical factors such as disease duration, myositis, and lung function impairment significantly influence treatment choices, offering valuable insights for future clinical trial design and personalized patient management.Abstract OC.01 Figure 1Combination therapies in patients treated in year ≥ 2017 according to the DMARD-based regimen (panel A mycophenolate mofetil-based regimens; panel B methotrexate-based regimens; panel C rituximab-based regimens and panel D tocilizumab-based regimens)