Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD): An Official 2025 ALAT Clinical Practice Guideline

Rheumatoid arthritis associated interstitial lung disease (RA-ILD) is a serious extra-articular manifestation, being the second cause of death in patients with RA. Usual interstitial pneumonia is the most frequent form of ILD with several factors resembling idiopathic pulmonary fibrosis. Early recognition of ILD through screening could change treatment strategies and prognosis in patients with RA. In this sense achieving articular activity remission included in the treat to target strategy becomes one of the most important factors not only to diminish the risk for developing ILD but also disease progression. Disease-modifying antirheumatic drugs (DMARDs) became the cornerstone for treating patients with RA-ILD together with antifibrotics for those with progressive pulmonary fibrosis. Therefore, this guideline aims to support early recognition and evidence -based management of this condition.