2023 American College of Rheumatology (ACR)/American College of Chest Physicians (CHEST) Guideline for the Treatment of Interstitial Lung Disease in People with Systemic Autoimmune Rheumatic Diseases

IF 3.7 2区医学 Q1 RHEUMATOLOGY

Arthritis Care & Research Pub Date : 2024-07-08 DOI:10.1002/acr.25348

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 the treatment of interstitial lung disease (ILD) in adults with systemic autoimmune rheumatic diseases (SARDs).

Methods

We developed clinically relevant population, intervention, comparator, and outcomes questions. A systematic literature review was then performed, and the available evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluation methodology. A panel of clinicians and patients reached consensus on the direction and strength of the recommendations.

Results

Thirty-five recommendations were generated (including two strong recommendations) for first-line SARD-ILD treatment, treatment of SARD-ILD progression despite first-line ILD therapy, and treatment of rapidly progressive ILD. The strong recommendations were against using glucocorticoids in systemic sclerosis–ILD as a first-line ILD therapy and after ILD progression. Otherwise, glucocorticoids are conditionally recommended for first-line ILD treatment in all other 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 treatment of ILD in people with SARDs.

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2023 美国风湿病学会 (ACR)/ 美国胸科医师学会 (CHEST) 《系统性自身免疫性风湿病患者间质性肺病治疗指南》。

摘要我们就系统性自身免疫性风湿病（SARDs）成人患者间质性肺病（ILD）的治疗提供循证建议：方法：我们提出了与临床相关的人群、干预措施、参照物和结果等问题。然后进行了系统的文献综述，并采用建议分级、评估、开发和评价方法对现有证据进行了评级。一个由临床医生和患者组成的小组就建议的方向和力度达成了共识：结果：针对一线 SARD-ILD 治疗、一线 ILD 治疗后 SARD-ILD 进展的治疗以及快速进展性 ILD 的治疗提出了 35 项建议（包括两项强力建议）。强烈建议反对将糖皮质激素用于系统性硬化-ILD 的一线 ILD 治疗和 ILD 进展后的治疗。否则，有条件地推荐糖皮质激素用于所有其他 SARDs 的一线 ILD 治疗：本临床实践指南首次提出了美国风湿病学会和美国胸科医师学会认可的治疗 SARDs 患者 ILD 的建议。

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

Arthritis Care & Research RHEUMATOLOGY-

CiteScore

9.40

自引率

6.40%

发文量

368

审稿时长

3-6 weeks

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.