4.2 Article

Detection and Monitoring of Interstitial Lung Disease in Patients with Systemic Sclerosis

Journal

CURRENT RHEUMATOLOGY REPORTS
Volume 24, Issue 5, Pages 166-173

Publisher

SPRINGER
DOI: 10.1007/s11926-022-01067-5

Keywords

Autoimmune diseases; Connective tissue disease; Pulmonary fibrosis; Scleroderma

Categories

Funding

  1. Boehringer Ingelheim Pharmaceuticals

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Interstitial lung disease (ILD) is a common manifestation of systemic sclerosis (SSc), and early detection, monitoring, and management are crucial. High-resolution computed tomography (HRCT) should be used for ILD screening at diagnosis, and regular monitoring including pulmonary function testing, symptom evaluation, and repeat HRCT is important. Multidisciplinary discussion is necessary for comprehensive evaluation and treatment decisions.
Purpose of Review Interstitial lung disease (ILD) is a common manifestation of systemic sclerosis (SSc). We explore the importance of early detection, monitoring, and management of SSc-ILD. Recent Findings All patients with SSc are at risk of ILD and should be screened for ILD at diagnosis using a high-resolution computed tomography (HRCT) scan. Some patients with SSc-ILD develop a progressive phenotype characterized by worsening fibrosis on HRCT, decline in lung function, and early mortality. To evaluate progression and inform treatment decisions, regular monitoring is important and should include pulmonary function testing, evaluation of symptoms and quality of life, and, where indicated, repeat HRCT. Multidisciplinary discussion enables comprehensive evaluation of the available information and its implications for management. The first-line treatment for SSc-ILD is usually immunosuppression. The antifibrotic drug nintedanib has been approved for slowing lung function decline in patients with SSc-ILD. Summary Optimal management of patients with SSc-ILD requires a multidisciplinary and patient-centered approach.

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