Recent Treatment of Interstitial Lung Disease with Idiopathic Inflammatory Myopathies

Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine

Review

Hisashi Yamanaka¹  Yasushi Kawaguchi¹  Hidenaga Kawasumi¹  Takahisa Gono¹ 

[1] Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.;

关键词: interstitial lung disease;    idiopathic inflammatory myopathies;    dermatomyositis;    polymyositis;    treatment;   

DOI  :  10.4137/CCRPM.S23313

 received in 2015-04-23, accepted in 2015-06-13,  发布年份 2015

来源: Sage Journals

【 摘 要 】

Interstitial lung disease (ILD) is a prognostic factor for poor outcome in polymyositis (PM)/dermatomyositis (DM). The appropriate management of ILD is very important to improve the prognosis of patients with PM/DM. ILD activity and severity depend on the disease subtype. Therefore, clinicians should determine therapeutic strategies according to the disease subtype in each patient with PM/DM. Anti–melanoma differentiation-associated gene 5 antibody and hyperferritinemia predict the development and severity of rapidly progressive (RP) ILD, particularly in East Asian patients. Combination therapy with corticosteroids, intravenous cyclophosphamide pulse, and calcineurin inhibitors should be administered in RP-ILD. In contrast, patients with anti–aminoacyl-tRNA synthetase (ARS) show better responses to corticosteroids alone. However, ILDs with anti-ARS often display disease recurrence or become refractory to corticosteroid monotherapy. Recent studies have demonstrated that the administration of tacrolimus or rituximab in addition to corticosteroids may be considered in ILD patients with anti-ARS. Large-scale, multicenter randomized clinical trials should be conducted in the future to confirm that the aforementioned agents exhibit efficacy in ILD patients with PM/DM. The pathophysiology of ILD with PM/DM should also be elucidated in greater detail to develop effective therapeutic strategies for patients with ILD in PM/DM.

【 授权许可】

CC BY-NC   
© 2015 SAGE Publications.