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Guidelines aim to help the identification of ILD in patients with rheumatic disease and aid in improving the management of patients.
The American College of Rheumatology (ACR) released 2 clinical practice guidelines for the screening, monitoring, and treatment of interstitial lung disease (ILD) in patients with systemic autoimmune rheumatic diseases (SARDs). These conditions include rheumatoid arthritis, systemic sclerosis (SSc), Mixed Connective Tissue Disease (MCTD), Sjögren's Disease (SjD), and idiopathic inflammatory myopathies (IIM), all of which are associated with the greatest risk of developing ILD. Recommendations aim to help the identification of ILD among this patient population and to aid in improving the co-management of patients with SARDs-ILD by pulmonologists and rheumatologists.
“Interstitial lung disease is a major cause of morbidity and mortality across several systemic autoimmune rheumatic diseases,” said Sindhu R Johnson, MD, PhD, lead author on the guidelines and director of the University of Toronto’s clinical epidemiology & healthcare research program, in a statement. “Guidance was needed for which tests to use for screening and monitoring this particular disease.”
The following recommendations are for the screening of SARD-ILD:
The following recommendations are for the monitoring of ILD progression:
The following recommendations are for the first-line ILD treatment in patients with SARDs-ILD:
The following are recommendations for the management of SARD-ILD despite first-line ILD treatment:
“We know that early detection and hastened referral to care, in collaboration with pulmonology, is critical for the best patient outcomes,” stated Sonye K Danoff, MD, PhD, guideline author, pulmonologist and director of the Interstitial Lung Disease/ Pulmonary Fibrosis program at Johns Hopkins University School of Medicine. “Because symptoms of ILD (cough, shortness of breath, fatigue) can be subtle or result from other common diseases, the diagnosis of ILD can be delayed. Increasing awareness of the groups at highest risk for developing ILD and implementing appropriate screening and treatment practices should have long-term benefits.”