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的筛查和监测指南》。

IF 3.7 2区 医学 Q1 RHEUMATOLOGY
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

摘要

目的:我们就系统性自身免疫性风湿病(SARDs),特别是类风湿性关节炎、系统性硬化症、特发性炎症性肌病、混合性结缔组织病和Sjögren病患者的间质性肺病(ILD)筛查和ILD进展监测提出了循证建议:我们提出了与 SARDs 患者 ILD 筛查和监测相关的临床相关人群、干预措施、比较对象和结果问题。我们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。由跨学科临床专家和患者组成的投票小组就每项建议的方向和力度达成了共识:结果:提出了 15 项建议。对于筛查有 ILD 风险的 SARDs 患者,我们有条件地建议进行肺功能检查 (PFT) 和胸部高分辨率计算机断层扫描 (HRCT);有条件地建议不要进行 6 分钟步行距离 (6MWD)、胸部放射摄影、非卧床低饱和度测试或支气管镜检查;强烈建议不要进行外科肺活检筛查。我们有条件地建议使用 PFT、胸部 HRCT 和非卧床饱和度检测对 ILD 进行监测,并有条件地建议不要使用 6MWD、胸片或支气管镜进行监测。我们提供了有关 ILD 危险因素的指导,并建议进行检查的频率,以评估 SARDs 患者 ILD 的发展情况: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筛查和监测 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。
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

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.

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来源期刊
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.
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