Introduction: Interstitial lung disease (ILD) is a substantial morbidity and mortality burden across many connective tissue disease (CTDs). Disease behavior of CT-ILD is highly variable and is often unpredictable. A multidisciplinary approach including pulmonologists and rheumatologists is important to define better therapeutic strategies and personalize the management of these patients.

Methods: Patients in this observational longitudinal study were seen jointly by a rheumatologist and a pulmonologist in Florence University Hospital between February 2022 and February 2023. For each case relevant clinical and radiological features were collected.

Results: 49 consecutive patients were included. The most prevalent diagnosis were systemic sclerosis-ILD (40.8%), rheumatoid arthritis-ILD (20.4%), antisynthetase syndrome (12.2%), Sjogren syndrome (12.2%), idiopathic pulmonary fibrosis (6.1%), psoriatic arthritis (6.1%) and undifferentiated connective tissue disease (4%). The most prevalent radiological pattern were NSIP (59.5%), UIP (23.8%), HP (4.7%) and OP (4.7%). The main reasons for referral to the unit were therapeutic assessment (48.8%) and evaluation of ILD progression (32.6%). 33 patients (67.3%) had a change or initiation of treatment.

Conclusion: We show the characteristics and management of our cohort of patients with CT-ILD. The most common CTDs associated with ILD were systemic sclerosis followed by rheumatoid arthritis. The most prevalent radiological pattern was NSIP. The simultaneous evaluation of a rheumatologist and a pulmonologist led to a change or initiation of treatment in more than two-third of the patients.