Results from a Novel Ongoing Prospective Screening Algorithm for Patients at risk for Interstitial Lung Disease

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Rationale: To date there is no validated screening algorithm that informs on chest CT timing in patients at risk for interstitial lung disease (ILD). Method: We initiated a novel prospective ILD screening algorithm. At inclusion all patients received a non-contrast prone HR-chest CT and thorough clinical investigation. ILD screening included a decline in functional vital capacity (FVC), diffusion capacity (DLCO), 6-minute walk test (6MWT), NYHA class or new velcro rales/dry cough (Fig. 1). Results: From 09/2021-10/2024 we recruited 309 patients without ILD (age 55 [IQR 47-64]yrs, 90% female). Baseline FVC, DLCO%sB and 6MWT for the total cohort were 99±16%pred, 85±18%pred and 426 (IQR 393-474)m, respectively and 72% were in NYHA class I. To date, N=262, n=182 and n=81 patients had 1, 2 or ≥3 follow-up visits, including N=53, N=41 and N=24 follow-up chest CTs, respectively. During follow-up, 2 deaths occurred, 42 patients developed mild (<10% affected lung area) and 5 significant ILD (>10%; N=4 SSc, N=1 RA), which occured median 22 (IQR 12-24)months after inclusion. In these 5 patients, FVC, DLCO and 6MWD declined by average -14%, -2% and -19m from baseline, respectively, 2 patients developed new velcro rales, while NYHA class was unchanged. Conclusion: A systematic screening algorithm in patients at-risk for ILD may support early ILD detection, potentially reducing the need for routine annual chest CTs. erj;66/suppl_69/PA3009/F1 F1 F1

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