Related to my last live tweet: Lung Disease Challenges in Myositis: Diagnosis, Treatment, and Screening
#ACR20 #ACRambassador
#ACR20 #ACRambassador
From Dr. Danoff--a pulmonologist's perspective
HRCT is incredibly important!
-Different ILD patterns predict outcomes and response to therapy
-Look for non-ILD findings that impact diagnosis and treatment: esophageal dilation, pulmonary artery dilation, pleuritis, tumors
HRCT is incredibly important!
-Different ILD patterns predict outcomes and response to therapy
-Look for non-ILD findings that impact diagnosis and treatment: esophageal dilation, pulmonary artery dilation, pleuritis, tumors
As a rheumatologist, NEVER forget that ILD can come first in myositis. With ILD + myositis specific antibody, you should have an extremely high suspicion for myositis even if there isn't extrapulmonary disease (yet). #rheumtwitter #ildtwitter
From Dr. Bernstein: an update on antifibrotics in CTD-ILD
First a discussion on SENSCIS trial. If you read my last livetweet, you'll remember that this compared nintedanib vs placebo. Many patients also received MMF or MTX. Nintedanib slowed the decline in FVC.
First a discussion on SENSCIS trial. If you read my last livetweet, you'll remember that this compared nintedanib vs placebo. Many patients also received MMF or MTX. Nintedanib slowed the decline in FVC.
Now INBUILD: Not specific for CTD-ILD! All patients with progressive fibrosing lung disease. Nintedanib did slow the rate of decline in the whole group.
26% of patients had CTD-ILD (RA-ILD, SSc-ILD, SS-ILD, etc). Nintedanib ALSO slowed the rate of decline in CTD-ILD subgroup.
26% of patients had CTD-ILD (RA-ILD, SSc-ILD, SS-ILD, etc). Nintedanib ALSO slowed the rate of decline in CTD-ILD subgroup.
Lots of upcoming studies on antifibrotics to get excited about!
Screening and treatment of myositis-associated ILD with Dr. Aggarwal
1st Q: Who should be screened? All myositis patients? High risk only? Certain antibodies only?
#ACR20 #ILDtwitter
1st Q: Who should be screened? All myositis patients? High risk only? Certain antibodies only?
#ACR20 #ILDtwitter
Definitely screen patients with high-risk antibodies: antisynthetase Abs, MDA5, and overlap antibodies (PM-Scl, U1RNP, Ku, and Ro).
Also screen those with clinical risk factors: older age, arthritis, fever, DM rashes, concerning labs, etc
Also screen those with clinical risk factors: older age, arthritis, fever, DM rashes, concerning labs, etc
To all the pulmonologists out there: Which ILD patients should be screened for myositis?
Dr. Aggarwal says ALL of them! ILD is very commonly the presenting manifestation of antisynthetase syndrome, MDA5, and other myositides. Do a myositis panel!
#ILDtwitter #Pulmtwitter #ACR20
Dr. Aggarwal says ALL of them! ILD is very commonly the presenting manifestation of antisynthetase syndrome, MDA5, and other myositides. Do a myositis panel!
#ILDtwitter #Pulmtwitter #ACR20
Dr. Aggarwal's treatment algorithm for myositis-ILD. Glucocorticoids for induction. MMF or AZA first line for mild-moderate disease. RTX or CYC for severe disease. Lots more second and third line options if needed.
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