A recent proof-of-concept study to evaluate nuclear imaging in interstitial lung disease (ILD) concludes it is feasible to study ILD subtypes using this technology to visualize specific molecular processes of ILD. The process has important potential applications for the development of targeted molecular therapies.1 ILD is an umbrella term for a group of heterogeneous lung…
In the past decade, the treat-to-target concept has gained broad acceptance. Both the ACR and European League Against Rheumatism (EULAR) management recommendations include adding biologic therapies to the treatment regimen for rheumatoid arthritis (RA) patients who do not sufficiently respond to methotrexate monotherapy. “What EULAR says is that if [methotrexate use fails], you should essentially…
New research has linked the risk of developing interstitial lung disease in rheumatoid arthritis patients with the promoter variant in MUC5B, which may also contribute to the development of idiopathic pulmonary fibrosis and an unsual interstitial pneumonia seen by high-resolution CT scan…
CHICAGO—Amid what she called a “dizzying array of choices” for rheumatoid arthritis (RA)—from anti-TNF and anti-IL6-receptor therapies to B cell depletion to new biosimilar options—disease treatment should still revolve around several basic concepts, an expert said at the ACR State-of-the-Art Clinical Symposium in April. Joan Bathon, MD, chief of rheumatology at Columbia University in New…
CHICAGO—About 30 years ago, pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) began to outpace renal crisis as the main causes of death in scleroderma (SSc). But treating these lung complications has proved vexing for clinicians. There is no easy way to predict who will develop PAH. There is no telltale antibody and no…
A recent systematic review found no clear evidence that rheumatoid arthritis patients treated with cyclophosphamide have better lung function than those treated with mycophenolate mofetil. The researchers caution that physicians should expect treatment with cyclophosphamide may only result in a modest improvement in the preservation of forced vital capacity…
SAN DIEGO—In Hot Topics in Myositis, a session held Nov. 7 at the 2017 ACR/ARHP Annual Meeting, rheumatologists discussed treating myositis patients in three different clinical scenarios: persistently elevated creatine kinase (CK), immune-mediated necrotizing myopathies and lung disease. Elevated CK Patients with persistently elevated levels of CK enzyme and normal muscle strength “may still have…
A recent prospective, observational cohort study of potential clinical biomarkers for progression to interstitial lung disease (ILD) in patients with early systemic sclerosis (SSc) found that higher levels of CCL2 circulating in their plasma predicted both faster ILD progression and poorer survival rates than in those with lower levels.1 CCL2, also known as monocyte chemoattractant…
Antisynthetase syndrome (AS) is strongly associated with the presence of antibodies to aminoacyl-transfer RNA (tRNA) synthetases (ARSs) that are implicated in the pathogenesis of myositis and interstitial lung disease (ILD). Antibodies against eight antisynthetases have been identified and are detected in 16–26% of patients with idiopathic inflammatory myopathies (IIM).1 Serum assays for five of these…
Multi-system diseases have unique challenges. And Dr. Aryeh Fischer says that when treating patients with interstitial lung disease, pulmonologists and rheumatologists must better understand “how we [both] approach our shared diseases.”