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…
Treatment Tips for Pulmonary Arterial Hypertension & ILD
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…
Cyclophosphamide for Connective Tissue Disease-Associated Interstitial Lung Disease
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…
Managing Myositis in 3 Different Scenarios
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…
CCL2 Cytokine Serves as Biomarker in Interstitial Lung Disease
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…
How to Diagnose Antisynthetase Syndrome
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…
What Our Colleagues Should Know: Integrated Care for the Lungs
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.”
From the Expert: New Advances in Treatment of Systemic Scleroderma
A recent study found that mycophenolate mofetil is an effective alternative for the treatment of systemic scleroderma with interstitial lung disease, resulting in possible long-term improvement. According to Aryeh Fischer, MD, this new research points to the future expansion of treatment options…
Listen to the Lungs: An Interview with Dr. Aryeh Fischer on ILD
In a recent interview, Aryeh Fischer, MD, addresses the importance of checking patients with autoimmune diseases for interstitial lung disease, noting that advances in technology and awareness can lead to early detection and affect patient outcomes…
Case Report: Interstitial Lung Disease with Positive ANCA Test
“Worst of all is the pain in my calves,” she said. “It feels like burning deep inside.” So began my first encounter with a 69-year-old woman who was referred to rheumatology clinic for evaluation of two months of constitutional symptoms and a positive ANCA test, which had been ordered by her primary care doctor. Her…