Interstitial Lung Disease Evaluation: Detecting Connective Tissue Disease

Fischer, Aryeh; Lee, Joyce; Cottin, Vincent

doi:10.1159/000440665

Cited by 38 publications

(16 citation statements)

References 41 publications

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“…Anti-aminoacyl-tRNA synthetase (anti-ARS) antibodies are known to be specific to polymyositis (PM)/dermatomyositis (DM) [1-3]. Among patients with anti-ARS antibodies there is a high frequency of interstitial lung disease (ILD) (ARS-ILD) (range: 71–100%) [2].…”

Section: Introductionmentioning

confidence: 99%

Predictive Factors for the Long-Term Deterioration of Pulmonary Function in Interstitial Lung Disease Associated with Anti-Aminoacyl-tRNA Synthetase Antibodies

et al. 2018

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Background: Little has been reported on long-term pulmonary function trends among patients with interstitial lung disease associated with anti-aminoacyl-tRNA synthetase antibodies (ARS-ILD). Objectives: To clarify the factors predictive of progression in ARS-ILD based on patients’ initial clinical and radiological features. Methods: The clinical courses of 88 patients with > 1 year of follow-up data on pulmonary function tests (PFTs) were retrospectively analyzed. Disease behavior was categorized into three groups: (1) improved or (2) worsened (defined as increases or decreases, respectively, of > 10% in forced vital capacity and > 15% in %diffusing capacity of lung carbon monoxide) or (3) stable based on PFT changes compared between 1-year results as the initial data and results at 3 years to assess the long-term course. Results: In the initial course of 75 patients with ARS-ILD who received anti-inflammatory therapy within 6 months after diagnosis, 48 patients (64.0%) improved and 6 patients (8.0%) worsened. The radiological patterns in the patients with ARS-ILD included nonspecific interstitial pneumonia (NSIP) in 46.7% and NSIP with organizing pneumonia overlap in 52.0% of the cases. One-third of the initially improved patients who worsened over the long-term course were assigned to the unstable group. By multivariate logistic analysis, middle lobe traction bronchiectasis was a significant predictive factor for the patients in the unstable group. Conclusions: Most patients with ARS-ILD receiving anti-inflammatory therapy had improved or remained stable in the first year. However, over the long-term course, some patients worsened despite their initial improvement. Even though the extent of the disease is limited, middle lobe traction bronchiectasis in ARS-ILD may be a useful predictor of poor long-term disease behavior.

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Section: Introductionmentioning

confidence: 99%

Predictive Factors for the Long-Term Deterioration of Pulmonary Function in Interstitial Lung Disease Associated with Anti-Aminoacyl-tRNA Synthetase Antibodies

et al. 2018

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“…Multidisciplinary teams should consider intrathoracic and extrathoracic disease activity. Similar to the approach taken with the diagnosis of idiopathic interstitial pneumonia [86], a clinical-radiological-pathological team approach can be used to improve the decision-making processes involved in CTD-ILD [8,12,87]. …”

Section: Multidisciplinary Discussionmentioning

confidence: 99%

“…The current definition fails to satisfy the rheumatological criteria for a definitive diagnosis of CTD [11], and fails to affirm the findings of serological tests. CTD-ILD is also known by the term “interstitial pneumonia with autoimmune features (IPAF)” [12]. It is difficult to provide a differential diagnosis of CTD-ILD with regard to drug toxicity and infection.…”

Section: Definition Of Connective Tissue Disease-associated Interstitmentioning

confidence: 99%

Treatment of connective tissue disease-associated interstitial lung disease: the pulmonologist’s point of view

Koo

2017

Korean J Intern Med

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Interstitial lung disease (ILD) occurs in 15% of patients with collagen vascular disease (CVD), referred to as connective tissue disease (CTD). Despite advances in management strategies, ILD continues to be a significant cause of mortality in patients with CVD-associated ILD (CTD-ILD). There is a lack of randomized, clinical trials assessing pharmacological agents for CTD-ILD, except in cases of ILD-associated systemic sclerosis (SSc). This may be due to the lack of CTD cases available, the difficulty of histological confirmation of ILD, and the various types of CTD and ILD. As a result, evidence-based pharmacological treatment of CTD-ILD is not yet well established. CTD-ILD presents with varying degrees of histology, from inflammation to fibrosis, and a wide spectrum of clinical manifestations, from minimal symptoms to respiratory failure. This renders it difficult for clinicians to make decisions regarding treatment options, observational strategies, optimal timing for interventions, and the appropriateness of pharmacological agents for treatment. There is no specific treatment for reversing fibrosis-like idiopathic pulmonary fibrosis in a clinical setting. This review describes pharmacological interventions for SSc-ILD described in randomized control trials, and presents an overview of recent advances of CTD-ILD-dependent treatments based on the types of CTD.

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“…7 Polymyositis/dermatomyositis is one of the traditional connective tissue diseases and categorised into idiopathic inflammatory myopathies. 8 9 It is triggered by unknown causes and progressed by an accelerated autoimmune reaction.…”

Section: Rationalementioning

confidence: 99%

Prognostic factors of idiopathic inflammatory myopathies complicated with interstitial lung disease: protocol for a systematic review and meta-analysis

Kamiya¹,

Panlaqui

Sozu

2016

BMJ Open

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IntroductionIdiopathic inflammatory myopathies may be an overlapping disease complex. Although interstitial lung disease affects the mortality and the morbidity of the disease, a clinical course and the prognosis of the disease complicated with interstitial lung disease are diverse among individuals and prognostic factors have yet to be clarified. This article aims to report the rationale and the methodology of a future intended systematic review and meta-analysis of prognostic factors of idiopathic inflammatory myopathies complicated with interstitial lung disease.Methods and analysisParticipants are eligible if they are diagnosed as polymyositis/dermatomyositis, clinically amyopathic dermatomyositis or antisynthetase syndrome complicated with interstitial lung disease. Primary outcomes are all-cause and pulmonary-cause mortality and secondary outcomes include a progression of the disease and a deterioration of health-related quality of life. All primary studies of any design aside from case reports or case series are included. 2 reviewers will search electronic databases such as the MEDLINE, the EMBASE and the Science Citation Index Expanded and extract relevant data independently. A risk of bias in individual studies is evaluated based on the Quality in Prognostic Studies tool. Meta-analysis will be conducted if 3 or more studies are available for each outcome and pooled effects will be presented by the odds ratio (OR). Where combining data is inappropriate due to a small number of studies or substantial heterogeneity, the result is reported qualitatively. Subgroup and sensitivity analysis are also considered based on clinical and methodological differences such as clinical manifestations, study designs and the quality of studies. The evidence level is assessed following the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) method.Ethics and disseminationThis study raises no ethical issues as it is based on the findings of previously published articles. The result will be reported in a peer-reviewed medical journal.Trial registration numberCRD42016036999.

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Interstitial Lung Disease Evaluation: Detecting Connective Tissue Disease

Cited by 38 publications

References 41 publications

Predictive Factors for the Long-Term Deterioration of Pulmonary Function in Interstitial Lung Disease Associated with Anti-Aminoacyl-tRNA Synthetase Antibodies

Predictive Factors for the Long-Term Deterioration of Pulmonary Function in Interstitial Lung Disease Associated with Anti-Aminoacyl-tRNA Synthetase Antibodies

Treatment of connective tissue disease-associated interstitial lung disease: the pulmonologist’s point of view

Prognostic factors of idiopathic inflammatory myopathies complicated with interstitial lung disease: protocol for a systematic review and meta-analysis

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