We read with great interest the multicentre study by Serrano-Combarro and colleagues evaluating abatacept in rheumatoid arthritis-associated interstitial lung disease (RA-ILD). The authors should be commended for assembling a large national real-world cohort and for addressing a clinically important question: whether the timing of abatacept initiation influences pulmonary outcomes. Their findings are reassuring. Over a median follow-up of 24 months, most patients experienced stability or improvement in forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLCO) and high-resolution computed tomography (HRCT), with concomitant improvement in DAS28-ESR and reduction in prednisone dose [1].
