Abstract Background/Aims Interstitial Lung Disease (ILD) comprises a group of lung disorders marked by fibrosis and/or inflammation, with up to a quarter recruited from systemic autoimmune rheumatic diseases associated interstitial lung diseases (SARD-ILD). These cases carry significant morbidity and are typically managed in tertiary centres, which can strain resources and burden patients. In 2019, our district general hospital (DGH) established a combined rheumatology-respiratory clinic to manage SARD-ILD locally. This study follows up on previous work evaluating outcomes of patients managed in this setting, including new cases. We evaluated outcomes of 170 patients to assess whether good outcomes were sustained and to support the viability of secondary care management for SARD-ILD. 77 patients were followed up from a previous study in 2019. Methods We conducted a retrospective study of patients seen in our combined rheumatology-respiratory SARD-ILD clinic between February 2016 and August 2025. Referrals from any hospital specialty were triaged via monthly ILD MDT meetings involving rheumatology, respiratory, radiology, and ILD nursing. Patients were assessed jointly by ILD-interested specialists. Demographics were recorded prospectively; full clinical data were collected retrospectively from electronic records. GP practices were contacted to confirm mortality data. Variables included demographics, diagnoses, symptoms, lung function (FVC, DLCO, 6MWT), HRCT results, and mortality, with prior investigations and imaging reviewed across electronic platforms. Results Of 170 patients, 79% (n = 131) had stable or improved symptoms. FVC improved or stabilised in 78% (n = 107), DLCO in 77% (n = 89), and 6MWT in 54% (n = 21). CT imaging showed stability or improvement in 86% (n = 127). Mortality was 17% (n = 28) by August 2025. Average time from rheumatological diagnosis to ILD onset was 67 months; average follow-up was 32.9 months. Mean comorbidities were 3.14. Of the 77 patients from the previous study, 70% (n = 31) had stable or improved symptoms. FVC improved or remained stable in 77% (n = 24), DLCO in 84% (n = 22), and 6MWT in 85% (n = 6). CT imaging showed stable or improved ILD in 83% (n = 30). 13 were discharged from clinic; 30 continue follow-up. ILD was the primary cause in only 7% of deaths. Conclusion This study supports the effectiveness of combined SARD-ILD clinics in secondary care. Over half of patients showed disease stability or improvement, including those followed for five years. Only four of 170 required tertiary referral, highlighting the model’s potential to deliver good outcomes locally and reduce pressure on tertiary centres. Disclosure J. Lynch: None. M. Patel: None. N. Ramsundar: None. V. Joshi: None. M.K. Nisar: None.
Lynch et al. (2026) studied this question.