Interstitial lung disease in systemic sclerosis: current and future treatment

Rheumatol Int. 2017 Jun;37(6):853-863. doi: 10.1007/s00296-016-3636-7. Epub 2017 Jan 6.

Abstract

Systemic sclerosis (SSc) has the highest fatality rate among connective tissue diseases and is characterized by vascular damage, inflammation and fibrosis of the skin and various internal organs. Interstitial lung disease (ILD) frequently complicates SSc and can be a debilitating disorder with a poor prognosis. ILD is the most frequent cause of death in SSc, and the management of SSc-ILD patients is a great challenge. Early detection of pulmonary involvement based on a recent decline of lung function tests and on the extent of lung involvement at high-resolution computed tomography is critical for the best management of these patients. This article summarizes classification, pathogenesis, diagnosis, prognosis, survival and finally current and future treatment options in SSc-ILD.

Keywords: Fibrosis; Interstitial lung disease; Scleroderma; Systemic sclerosis; Treatment.

Publication types

  • Review

MeSH terms

  • Animals
  • Early Diagnosis
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use*
  • Lung / drug effects*
  • Lung / pathology
  • Lung / physiopathology
  • Lung / surgery
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / mortality
  • Lung Diseases, Interstitial / physiopathology
  • Lung Diseases, Interstitial / therapy*
  • Lung Transplantation
  • Molecular Targeted Therapy
  • Predictive Value of Tests
  • Respiratory Function Tests
  • Risk Factors
  • Scleroderma, Systemic / diagnosis
  • Scleroderma, Systemic / mortality
  • Scleroderma, Systemic / physiopathology
  • Scleroderma, Systemic / therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Immunosuppressive Agents