2023 American College of Rheumatology (ACR)/American College of Chest Physicians (CHEST) Guideline for the Screening and Monitoring of Interstitial Lung Disease in People with Systemic Autoimmune Rheumatic Diseases
Sindhu R. Johnson, Elana J. Bernstein, Marcy B. Bolster, Jonathan H. Chung, Sonye K. Danoff, Michael D. George, Dinesh Khanna, Gordon Guyatt, Reza D. Mirza, Rohit Aggarwal, Aberdeen Allen Jr, Shervin Assassi, Lenore Buckley, Hassan A. Chami, Douglas S. Corwin, Paul F. Dellaripa, Robyn T. Domsic, Tracy J. Doyle, Catherine Marie Falardeau, Tracy M. Frech, Fiona K. Gibbons, Monique Hinchcliff, Cheilonda Johnson, Jeffrey P. Kanne, John S. Kim, Sian Yik Lim, Scott Matson, Zsuzsanna H. McMahan, Samantha J. Merck, Kiana Nesbitt, Mary Beth Scholand, Lee Shapiro, Christine D. Sharkey, Ross Summer, John Varga, Anil Warrier, Sandeep K. Agarwal, Danielle Antin-Ozerkis, Bradford Bemiss, Vaidehi Chowdhary, Jane E. Dematte D'Amico, Robert Hallowell, Alicia M. Hinze, Patil A. Injean, Nikhil Jiwrajka, Elena K. Joerns, Joyce S. Lee, Ashima Makol, Gregory C. McDermott, Jake G. Natalini, Justin M. Oldham, Didem Saygin, Kimberly Showalter Lakin, Namrata Singh, Joshua J. Solomon, Jeffrey A. Sparks, Marat Turgunbaev, Samera Vaseer, Amy Turner, Stacey Uhl, Ilya Ivlev
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引用次数: 0
Abstract
Objective
We provide evidence-based recommendations regarding screening for interstitial lung disease (ILD) and the monitoring for ILD progression in people with systemic autoimmune rheumatic diseases (SARDs), specifically rheumatoid arthritis, systemic sclerosis, idiopathic inflammatory myopathies, mixed connective tissue disease, and Sjögren disease.
Methods
We developed clinically relevant population, intervention, comparator, and outcomes questions related to screening and monitoring for ILD in patients with SARDs. A systematic literature review was performed, and the available evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation methodology. A Voting Panel of interdisciplinary clinician experts and patients achieved consensus on the direction and strength of each recommendation.
Results
Fifteen recommendations were developed. For screening people with these SARDs at risk for ILD, we conditionally recommend pulmonary function tests (PFTs) and high-resolution computed tomography of the chest (HRCT chest); conditionally recommend against screening with 6-minute walk test distance (6MWD), chest radiography, ambulatory desaturation testing, or bronchoscopy; and strongly recommend against screening with surgical lung biopsy. We conditionally recommend monitoring ILD with PFTs, HRCT chest, and ambulatory desaturation testing and conditionally recommend against monitoring with 6MWD, chest radiography, or bronchoscopy. We provide guidance on ILD risk factors and suggestions on frequency of testing to evaluate for the development of ILD in people with SARDs.
Conclusion
This clinical practice guideline presents the first recommendations endorsed by the American College of Rheumatology and American College of Chest Physicians for the screening and monitoring of ILD in people with SARDs.
期刊介绍：
Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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