ABS0548 DEVELOPMENT OF A PHYSICIAN-INDEPENDENT SCREENING FOR RA-ILD: AN OLIGO- AND MONOCENTRIC COHORT STUDY

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Background: Interstitial lung disease (ILD) is a leading cause of death in patients with rheumatoid disease [1]. While diagnostic delay is linked to increased mortality [2] early detection is mandatory. Objectives: This study aimed to provide a physician-independent screening questionnaire for rheumatoid arthritis-associated interstitial lung disease (RA-ILD). Methods: We developed a 26-item questionnaire on ILD-symptoms consisting of a 10-point visual analog scale for building a sum score. The questionnaire was evaluated, adapted, and validated in two steps. Multiple imputation handled missing data. First, an item- and principal component analysis was performed in patients with ILD and healthy controls using a multicenter approach. To test for score differences an independent t-test was executed. The effect size was estimated using Cohen‘s d. As a measure of internal consistency, McDonald's omega was calculated. Second, for questionnaire validation patients diagnosed with ACPA (anti-citrullinated peptide antibodies) and RF (rheumatoid factor)-positive RA according to ACR criteria without previous known pulmonary examination were monocentrically recruited. ILD was confirmed or excluded by lung ultrasound of 14 intercostal spaces. A Receiver Operating Characteristics (ROC)-analysis was performed. Results: In total, 174 patients with ILD (46% female, mean age 62 ± 13 years, mean score 39 (95 %-CI[43;35])) and 67 healthy controls (49% female, mean age 59 ± 12 years; mean score 8 (95 %-CI[12;4])) were included. The independent t-test revealed a significant score difference of 31 points (95 %-CI[36;26])) associated with large effect size, t(85 358,44) = –11,71, p < 0,001, d=|1,36|. A McDonald's omega of 0,93 indicated excellent internal consistency. For validation, 101 patients (75% female, mean age 59 ± 12 years, mean disease duration 9 ± 6 years, mean score 14 (95 %-CI[18;11])) were recruited. Nine patients (89% female, mean age 64 ± 8 years, mean disease duration 9 ± 5 years, mean score 21 (95 %-CI[34;8])) were diagnosed with RA-ILD. The ROC analysis showed a pooled area under the curve (AUC) of 0,63, resulting in a cut-off score of 7. Conclusion: The questionnaire obtained promising results as a physician-independent and economical screening tool for RA-ILD. REFERENCES: [1] Kadura S, Raghu G. Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management. Eur Respir Rev. 2021;30(160). [2] Cano-Jiménez E, Vázquez Rodríguez T, Martín-Robles I, Castillo Villegas D, Juan García J, Bollo de Miguel E, et al. Diagnostic delay of associated interstitial lung disease increases mortality in rheumatoid arthritis. Sci Rep. 2021;11(1):9184. Acknowledgements: NIL . Disclosure of Interests: Robin Tiede Boehringer Ingelheim, Frank Reichenberger Boehringer Ingelheim, Boehringer Ingelheim, Carina Fischinger Boehringer Ingelheim, Martin Schwaiblmair Boehringer Ingelheim & Roche, Joachim Meyer: None declared, Josef Benedikter: None declared, Florian Popp Boehringer Ingelheim, Claudia Dechant: None declared, Susanna Spaethling-Mestekemper Boehringer Ingelheim, Klaus Thürmel: None declared, Matthias Wahle Boehringer Ingelheim, Boehringer Ingelheim, Sven Waßmann: None declared, Nikolaus Kneidinger Boehringer Ingelheim, Martin Welcker Abbvie, BMS, Boehringer, Fresenius, Galapagos, Gilead, GSK, Hexal, Janssen, Johnson & Johnson, Medac, Mylan, Novartis, Sanofi-Aventis, UCB, Viatris, Abbvie, BMS, Boehringer, Fresenius, Galapagos, Gilead, GSK, Hexal, Janssen, Johnson & Johnson, Medac, Mylan, Novartis, Sanofi-Aventis, UCB, Viatris, Novatis, Boehringer Ingelheim, UCD. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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