Intermittent intravenous cyclophosphamide pulse therapy for the treatment of active interstitial lung disease associated with collagen vascular diseases

Okada, Makoto; Suzuki, Kimihiro; Matsumoto, Mitsuyo; Nakashima, Masahiro; Nakanishi, Takashi; Takada, Kunio; Horikoshi, Hiroyuki; Matsubara, Osamu; Ohsuzu, Fumitaka

doi:10.1007/s10165-007-0554-2

Cited by 15 publications

(8 citation statements)

References 21 publications

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“…New onset or deterioration of ILD occurred in 4 patients and was associated with a rapid increase in serum KL-6 levels. Reflecting its potential use in serial monitoring of disease activity, levels of KL-6 have been shown to decrease after treatment with cyclophosphamide [34]. Satoh et al evaluated the prognostic significance of serum KL-6 levels in 219 patients with ILD, including 67 with CTD-ILD.…”

Section: Alveolar Epithelial Proteinsmentioning

confidence: 99%

Circulating Biomarkers of Interstitial Lung Disease in Systemic Sclerosis

Lota

Renzoni

2012

International Journal of Rheumatology

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Interstitial lung disease (ILD) is a major cause of morbidity and mortality in patients with systemic sclerosis (SSc). Although a large proportion of SSc patients have only limited interstitial involvement with an indolent course, in a significant minority ILD is progressive, requiring prompt treatment and careful monitoring. One of the main challenges for the clinician treating this highly variable disease is the early identification of patients at risk of progressive ILD, while avoiding potentially toxic treatments in those whose disease is inherently stable. Easily available and repeatable biomarkers that allow estimation of the risk of ILD progression and early response to treatment are highly desirable. In this paper, we review the evidence for circulating biomarkers with potential roles in diagnosis, monitoring of disease activity, or determining prognosis. Peripheral blood biomarkers offer the advantages of being readily obtained, non-invasive, and serially monitored. Several possible candidates have emerged from studies performed so far, including SP-D, KL-6, and CCL18. Presently however, there are few prospective studies evaluating the predictive ability of prospective biomarkers after adjustment for disease severity. Future carefully designed, prospective studies of well characterised patients with ILD, with optimal definition of disease severity and outcome measures are needed.

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Section: Alveolar Epithelial Proteinsmentioning

confidence: 99%

Circulating Biomarkers of Interstitial Lung Disease in Systemic Sclerosis

Lota

Renzoni

2012

International Journal of Rheumatology

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“…Interstitial pneumonitis is a less frequent occurrence in SLE than other CTDs and has received less attention than other CTD-ILDs, particularly SSc-ILD, but it shares similar pathogenic mechanisms ( 98 ). The most frequent histopathology types are acute interstitial pneumonia and NSIP, and high-resolution CT of the lung shows ground glass opacities ( 99 , 100 ).…”

Section: Connective Tissue Disease-associated Lung Diseasesmentioning

confidence: 99%

Immune-mediated lung diseases: A narrative review

Sweis

Alnaimat

et al. 2023

Front. Med.

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The role of immunity in the pathogenesis of various pulmonary diseases, particularly interstitial lung diseases (ILDs), is being increasingly appreciated as mechanistic discoveries advance our knowledge in the field. Immune-mediated lung diseases demonstrate clinical and immunological heterogeneity and can be etiologically categorized into connective tissue disease (CTD)-associated, exposure-related, idiopathic, and other miscellaneous lung diseases including sarcoidosis, and post-lung transplant ILD. The immunopathogenesis of many of these diseases remains poorly defined and possibly involves either immune dysregulation, abnormal healing, chronic inflammation, or a combination of these, often in a background of genetic susceptibility. The heterogeneity and complex immunopathogenesis of ILDs complicate management, and thus a collaborative treatment team should work toward an individualized approach to address the unique needs of each patient. Current management of immune-mediated lung diseases is challenging; the choice of therapy is etiology-driven and includes corticosteroids, immunomodulatory drugs such as methotrexate, cyclophosphamide and mycophenolate mofetil, rituximab, or other measures such as discontinuation or avoidance of the inciting agent in exposure-related ILDs. Antifibrotic therapy is approved for some of the ILDs (e.g., idiopathic pulmonary fibrosis) and is being investigated for many others and has shown promising preliminary results. A dire need for advances in the management of immune-mediated lung disease persists in the absence of standardized management guidelines.

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“…However, data on the use of immunosuppressive drugs in SLE-ILD are insubstantial. [68][69][70] For patients affected with mild to moderate forms, AZA or MMF may be considered, while in the severe or rapidly progressive cases, CYC or RTX should be preferred. In the setting of a severe ILD flare, characterized by hypoxemia and marked impairment by PFTs, high dose of systemic GCs (i.e.…”

Section: Pleuritismentioning

confidence: 99%

Diagnosis and management of lung involvement in systemic lupus erythematosus and Sjögren’s syndrome: a literature review

Depascale

Frate

Gasparotto

et al. 2021

Therapeutic Advances in Musculoskeletal

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Lung involvement in systemic lupus erythematosus (SLE) and primary Sjögren’s syndrome (pSS) has extensively been outlined with a multiplicity of different manifestations. In SLE, the most frequent finding is pleural effusion, while in pSS, airway disease and parenchymal disorders prevail. In both cases, there is an increased risk of pre-capillary and post-capillary pulmonary arterial hypertension (PAH) and pulmonary venous thromboembolism (VTE). The risk of VTE is in part due to an increased thrombophilic status secondary to systemic inflammation or to the well-established association with antiphospholipid antibody syndrome (APS). The lung can also be the site of an organ-specific complication due to the aberrant pathologic immune-hyperactivation as occurs in the development of lymphoma or amyloidosis in pSS. Respiratory infections are a major issue to be addressed when approaching the differential diagnosis, and their exclusion is required to safely start an immunosuppressive therapy. Treatment strategy is mainly based on glucocorticoids (GCs) and immunosuppressants, with a variable response according to the primary pathologic process. Anticoagulation is recommended in case of VTE and multi-targeted treatment regimens including different drugs are the mainstay for PAH management. Antibiotics and respiratory physiotherapy can be considered relevant complement therapeutic measures. In this article, we reviewed lung manifestations in SLE and pSS with the aim to provide a comprehensive overview of their diagnosis and management to physicians taking care of patients with connective tissue diseases.

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Intermittent intravenous cyclophosphamide pulse therapy for the treatment of active interstitial lung disease associated with collagen vascular diseases

Cited by 15 publications

References 21 publications

Circulating Biomarkers of Interstitial Lung Disease in Systemic Sclerosis

Circulating Biomarkers of Interstitial Lung Disease in Systemic Sclerosis

Immune-mediated lung diseases: A narrative review

Diagnosis and management of lung involvement in systemic lupus erythematosus and Sjögren’s syndrome: a literature review

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