Symposium 4

Vanessa Smith
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Abstract

Interstitial lung disease (ILD) is a fibrotic disease of the lung parenchyma. It can occur in different connective tissue diseases, including rheumatoid arthritis (RA). Smoking, male gender and longstanding RA are possible risk factors for developing ILD 1 . Being a common extra-articular manifestation of RA, it can contribute to decreased quality of life, chronic disability, high utilization of healthcare resources, and may also lead to substantial morbidity and mortality for affected patients1. Hence, early identification and management is of paramount importance to improve patient outcomes. Clinical presentation, chest X-ray, pulmonary function testing and high-resolution computed tomography are common tools for investigation and they also allows assessment of subtype and disease extent 2 . The histopathologic and radiographic features of RA-ILD are heterogeneous. The most frequent patterns of RA-ILD are usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP). Distinguishing the patterns is useful in predicting prognosis and would also affect subsequent management approach 2 . Traditionally treatment initiated for RA-ILD was generally empirical. Corticosteroids were often used as first-line agents and immunosuppressants maybe added2. However, these treatments are not specific and mainly target inflammation instead of fibrosis. With the advance in medicine, antifibrotic is now indicated for treating fibrosing ILD with progressive phenotype. FVC decline can be slowed in patients with connective tissue disease associated progressive ILD 3 . In this lecture, Prof. Vanessa Smith will share the current knowledge and evidence in RA-ILD. The approach on identifying and screening ILD in RA patients would be presented. The management strategy and options would also be reviewed.
第 4 专题讨论会
间质性肺病(ILD)是一种肺实质纤维化疾病。它可发生于不同的结缔组织疾病,包括类风湿性关节炎(RA)。吸烟、男性和长期的类风湿性关节炎可能是导致 ILD 的危险因素 1 。作为 RA 常见的关节外表现,ILD 可导致患者生活质量下降、长期残疾、医疗资源使用率高,还可能导致患者大量发病和死亡1。因此,早期识别和治疗对改善患者预后至关重要。临床表现、胸部 X 光检查、肺功能测试和高分辨率计算机断层扫描是常用的检查工具,它们还可以评估亚型和疾病范围2 。RA-ILD 的组织病理学和放射学特征各不相同。RA-ILD 最常见的模式是寻常性间质性肺炎(UIP)和非特异性间质性肺炎(NSIP)。区分这两种模式有助于预测预后,也会影响后续的治疗方法2。传统上,RA-ILD 的治疗通常是经验性的。皮质类固醇通常被用作一线药物,也可能添加免疫抑制剂2。然而,这些治疗方法没有特异性,主要针对炎症而非纤维化。随着医学的进步,抗纤维化药物现已适用于治疗具有进行性表型的纤维化 ILD。结缔组织病相关进展性 ILD 患者的 FVC 下降速度可以减慢3。在本讲座中,Vanessa Smith 教授将与大家分享当前有关 RA-ILD 的知识和证据。她将介绍识别和筛查RA患者ILD的方法。此外,还将回顾管理策略和方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
自引率
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发文量
13
审稿时长
12 weeks
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