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

Sindhu R Johnson¹, Elana J Bernstein², Marcy B Bolster³, Jonathan H Chung⁴, Sonye K Danoff⁵, Michael D George⁶, Dinesh Khanna⁷, Gordon Guyatt⁸, Reza D Mirza⁸, Rohit Aggarwal⁹, Aberdeen Allen Jr¹⁰, Shervin Assassi¹¹, Lenore Buckley¹², Hassan A Chami⁵, Douglas S Corwin¹³, Paul F Dellaripa¹⁴, Robyn T Domsic⁹, Tracy J Doyle¹⁴, Catherine Marie Falardeau¹⁵, Tracy M Frech¹⁶, Fiona K Gibbons³, Monique Hinchcliff¹², Cheilonda Johnson⁶, Jeffrey P Kanne¹⁷, John S Kim¹⁸, Sian Yik Lim¹⁹, Scott Matson²⁰, Zsuzsanna H McMahan⁵, Samantha J Merck²¹, Kiana Nesbitt²², Mary Beth Scholand²³, Lee Shapiro²⁴, Christine D Sharkey¹⁷, Ross Summer²⁵, John Varga⁷, Anil Warrier²⁶, Sandeep K Agarwal²⁷, Danielle Antin-Ozerkis¹², Bradford Bemiss²⁸, Vaidehi Chowdhary¹², Jane E Dematte D'Amico²⁸, Robert Hallowell³, Alicia M Hinze²⁹, Patil A Injean³⁰, Nikhil Jiwrajka⁶, Elena K Joerns³¹, Joyce S Lee³², Ashima Makol²⁹, Gregory C McDermott¹⁴, Jake G Natalini³³, Justin M Oldham⁷, Didem Saygin⁹, Kimberly Showalter Lakin³⁴, Namrata Singh³⁵, Joshua J Solomon³⁶, Jeffrey A Sparks¹⁴, Marat Turgunbaev³⁷, Samera Vaseer³⁸, Amy Turner³⁷, Stacey Uhl³⁹, Ilya Ivlev³⁹

Affiliations

¹ University of Toronto, Schroeder Arthritis Institute, Toronto Western Hospital, Mount Sinai Hospital, Toronto, Ontario, Canada.
² Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York City.
³ Massachusetts General Hospital, Boston.
⁴ The University of Chicago Medicine, Chicago, Illinois.
⁵ Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁶ University of Pennsylvania, Philadelphia.
⁷ University of Michigan, Ann Arbor.
⁸ McMaster University, Hamilton, Ontario, Canada.
⁹ University of Pittsburgh, Pittsburgh, Pennsylvania.
¹⁰ Parlin, New, Jersey.
¹¹ University of Texas Health Science Center at Houston.
¹² Yale School of Medicine, New Haven, Connecticut.
¹³ St. Luke's University Health Network, Bethlehem, Pennsylvania.
¹⁴ Brigham and Women's Hospital, Boston, Massachusetts.
¹⁵ Kissimmee, Florida.
¹⁶ Vanderbilt University Medical Center, Nashville, Tennessee.
¹⁷ University of Wisconsin School of Medicine and Public Health, Madison.
¹⁸ University of Virginia School of Medicine, Charlottesville.
¹⁹ Hawaii Pacific Health, Aiea.
²⁰ University of Kansas Medical Center, Kansas City.
²¹ Saint Francis Health System, Tulsa, Oklahoma.
²² Lansdowne, Pennsylvania.
²³ University of Utah, Salt Lake City.
²⁴ Albany Medical College, Albany, New York.
²⁵ Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
²⁶ Millennium Physicians, Huntsville, Texas.
²⁷ Baylor College of Medicine, Houston, Texas.
²⁸ Northwestern University, Chicago, Illinois.
²⁹ Mayo Clinic, Rochester, Minnesota.
³⁰ Cedars-Sinai, Los Angeles, California.
³¹ UT Southwestern Medical Center, Dallas, Texas.
³² University of Colorado Denver, Aurora.
³³ New York University Langone Health, New York City.
³⁴ Hospital for Special Surgery, Weill Cornell Medicine, New York City.
³⁵ University of Washington, Seattle.
³⁶ National Jewish Health, Denver, Colorado.
³⁷ American College of Rheumatology, Atlanta, Georgia.
³⁸ University of Oklahoma, Oklahoma City.
³⁹ Center for Clinical Evidence and Guidelines, Plymouth Meeting, Pennsylvania.

PMID: 38978310
DOI: 10.1002/art.42861

Free article

Practice Guideline

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

Sindhu R Johnson et al. Arthritis Rheumatol. 2024 Aug.

Free article

. 2024 Aug;76(8):1182-1200.

doi: 10.1002/art.42861. Epub 2024 Jul 8.

Authors

Affiliations

¹ University of Toronto, Schroeder Arthritis Institute, Toronto Western Hospital, Mount Sinai Hospital, Toronto, Ontario, Canada.
² Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York City.
³ Massachusetts General Hospital, Boston.
⁴ The University of Chicago Medicine, Chicago, Illinois.
⁵ Johns Hopkins University School of Medicine, Baltimore, Maryland.
⁶ University of Pennsylvania, Philadelphia.
⁷ University of Michigan, Ann Arbor.
⁸ McMaster University, Hamilton, Ontario, Canada.
⁹ University of Pittsburgh, Pittsburgh, Pennsylvania.
¹⁰ Parlin, New, Jersey.
¹¹ University of Texas Health Science Center at Houston.
¹² Yale School of Medicine, New Haven, Connecticut.
¹³ St. Luke's University Health Network, Bethlehem, Pennsylvania.
¹⁴ Brigham and Women's Hospital, Boston, Massachusetts.
¹⁵ Kissimmee, Florida.
¹⁶ Vanderbilt University Medical Center, Nashville, Tennessee.
¹⁷ University of Wisconsin School of Medicine and Public Health, Madison.
¹⁸ University of Virginia School of Medicine, Charlottesville.
¹⁹ Hawaii Pacific Health, Aiea.
²⁰ University of Kansas Medical Center, Kansas City.
²¹ Saint Francis Health System, Tulsa, Oklahoma.
²² Lansdowne, Pennsylvania.
²³ University of Utah, Salt Lake City.
²⁴ Albany Medical College, Albany, New York.
²⁵ Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
²⁶ Millennium Physicians, Huntsville, Texas.
²⁷ Baylor College of Medicine, Houston, Texas.
²⁸ Northwestern University, Chicago, Illinois.
²⁹ Mayo Clinic, Rochester, Minnesota.
³⁰ Cedars-Sinai, Los Angeles, California.
³¹ UT Southwestern Medical Center, Dallas, Texas.
³² University of Colorado Denver, Aurora.
³³ New York University Langone Health, New York City.
³⁴ Hospital for Special Surgery, Weill Cornell Medicine, New York City.
³⁵ University of Washington, Seattle.
³⁶ National Jewish Health, Denver, Colorado.
³⁷ American College of Rheumatology, Atlanta, Georgia.
³⁸ University of Oklahoma, Oklahoma City.
³⁹ Center for Clinical Evidence and Guidelines, Plymouth Meeting, Pennsylvania.

PMID: 38978310
DOI: 10.1002/art.42861

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.

PubMed Disclaimer

References

REFERENCES

1. Johnson SR, Berstein EJ, Bolster MB, et al. 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. Arthritis Rheumatol 2024;76(8):1201–1213.
1. Fischer A, du Bois R. Interstitial lung disease in connective tissue disorders. Lancet 2012;380:689–698.
1. Fischer A, Strek ME, Cottin V, et al. Proceedings of the American College of Rheumatology/Association of Physicians of Great Britain and Ireland Connective Tissue Disease‐Associated Interstitial Lung Disease Summit: a multidisciplinary approach to address challenges and opportunities. Arthritis Rheumatol 2019;71:182–195.
1. Andrews JC, Schünemann HJ, Oxman AD, et al. GRADE guidelines: 15. Going from evidence to recommendation‐determinants of a recommendation's direction and strength. J Clin Epidemiol 2013;66:726–735.
1. Guyatt GH, Oxman AD, Vist GE, et al; GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924–926.

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical