Lancet Rheumatol

TNF therapies appear safe in RA-associated interstitial lung disease

January 15, 2025

Clinical impact: Tumor necrosis factor (TNF) inhibitors and non-TNF disease-modifying antirheumatic drugs (DMARDs) showed similar outcomes in U.S. veterans with rheumatoid arthritis-associated interstitial lung disease (RA-ILD), suggesting that TNF inhibitors shouldn't be universally avoided. Further trials are needed to address potential biases in observational studies.

Study details: This retrospective, active-comparator, new-user cohort study analyzed data from U.S. veterans diagnosed with RA-ILD. The study compared the effectiveness of TNF inhibitors and non-TNF biologic or targeted synthetic DMARDs initiated between 2006 and 2022. The primary outcomes were mortality, respiratory hospitalizations, and changes in lung function over a three-year follow-up period.

Results: Both TNF inhibitors and non-TNF biologic or targeted synthetic DMARDs were associated with improved survival and reduced respiratory hospitalizations. Specifically, death and respiratory hospitalization didn’t significantly differ between groups (adjusted hazard ratio, 1.21; 95% confidence interval, 0.92-1.58).

Sources:

England BR, et al. (2025, January 7). Lancet Rheumatol. Advanced therapies in US veterans with rheumatoid arthritis-associated interstitial lung disease: a retrospective, active-comparator, new-user, cohort study. https://pubmed.ncbi.nlm.nih.gov/39793598/