"Management of myositis associated interstitial lung disease".
Lorraine ThongLiam J ChawkeGrainne MurphyMichael T HenryPublished in: Rheumatology international (2023)
Idiopathic inflammatory myopathies (IIM) are rare disorders characterised by the presence of skeletal muscle inflammation, with interstitial lung disease (ILD) being the most frequent pulmonary manifestation. The spectrum of clinical presentations of myositis related ILD (M-ILD) encompasses a chronic process to a rapidly progressive ILD (RP-ILD); which is associated with a high mortality rate. The most effective treatments remain controversial and poses a unique challenge to both rheumatologists and respiratory physicians to manage. Given the rare heterogenous nature of M-ILD, there is a paucity of data to guide treatment. The cornerstone of existing treatments encompasses combinations of immunosuppressive therapies, as well as non-pharmacological therapies. In this review, we aim to summarize the current pharmacological therapies (including its dosing regimens and side effects profiles) and non-pharmacological therapies. Based on the existing literature to date, we propose a treatment algorithm for both chronic M-ILD and RP-ILD.
Keyphrases
- interstitial lung disease
- systemic sclerosis
- rheumatoid arthritis
- idiopathic pulmonary fibrosis
- skeletal muscle
- oxidative stress
- multiple sclerosis
- primary care
- machine learning
- type diabetes
- insulin resistance
- systematic review
- deep learning
- risk factors
- combination therapy
- electronic health record
- cardiovascular events
- big data
- artificial intelligence
- smoking cessation