Recommendations for the Treatment of Anti-Melanoma Differentiation-Associated Gene 5-positive Dermatomyositis-Associated Rapidly Progressive Interstitial Lung Disease

Autor: Ivan Castellví, T Gono, Juan Carlos Ruiz-Rodríguez, Olga Sánchez-Pernaute, X. Solanich, Maria N Plana, P Diaz Del Campo, Iago Pinal-Fernandez, Medra, Albert Selva-O'Callaghan, Fredeswinda Romero-Bueno, M J Martínez-Becerra, Ernesto Trallero-Araguás, Miguel A. González-Gay, María Jesús Rodríguez-Nieto
Přispěvatelé: Universidad de Cantabria
Rok vydání: 2020
Předmět:
Lung Transplant
Interferon-Induced Helicase
IFIH1
medicine.medical_treatment
Review
Cochrane Library
Basiliximab
0302 clinical medicine
Glucocorticoid
030212 general & internal medicine
Intravenous Immunoglobulins
Interstitial lung disease
Syndrome
Plasmapheresis
Rapidly Progressive Interstitial Lung Disease
Pulmonology
Cyclosporine
Drug Therapy
Combination
Rituximab
Immunosuppressive Agents
medicine.drug
Systematic
medicine.medical_specialty
Consensus
MEDLINE
Polymixyn B Hemoperfusion
Dermatomyositis
Tacrolimus
03 medical and health sciences
Extracorporeal Membrane Oxygenation
Rheumatology
Internal medicine
Intensive care
medicine
Humans
Mycophenolate
Intensive care medicine
Glucocorticoids
Contraindication
Cyclophosphamide
030203 arthritis & rheumatology
business.industry
Intensive Care
medicine.disease
Anesthesiology and Pain Medicine
Tofacitinib
Lung Diseases
Interstitial
business
Zdroj: Semin Arthritis Rheum . 2020 Jun 1;50(4):776-790
UCrea Repositorio Abierto de la Universidad de Cantabria
Universidad de Cantabria (UC)
SEMINARS IN ARTHRITIS AND RHEUMATISM
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
ISSN: 0049-0172
Popis: Objectives: The study aimed to develop evidence-based recommendations for the treatment of rapidly progressive interstitial lung disease (RPILD) associated with the anti-Melanoma Differentiation-Associated Gene 5-positive dermatomyositis (DM) syndrome. Methods: The task force comprised an expert panel of specialists in rheumatology, intensive care medicine, pulmonology, immunology, and internal medicine. The study was carried out in two phases: identifying key areas in the management of DM-RPILD syndrome and developing a set of recommendations based on a review of the available scientific evidence. Four specific questions focused on different treatment options were identified. Relevant publications in English, Spanish or French up to April 2018 were searched systematically for each topic using PubMed (MEDLINE), EMBASE, and Cochrane Library (Wiley Online). The experts used evidence obtained from these studies to develop recommendations. Results: A total of 134 studies met eligibility criteria and formed the evidentiary basis for the recommendations regarding immunosuppressive therapy and complementary treatments. Overall, there was general agreement on the initial use of combined immunosuppressive therapy. Combination of high-dose glucocorticoids and calcineurin antagonists with or without cyclophosphamide is the first choice. In the case of calcineurin antagonist contraindication or treatment failure, switching or adding other immunosuppressants may be individualized. Plasmapheresis, polymyxin B hemoperfusion and/or intravenous immunoglobulins may be used as rescue options. ECMO should be considered in life-threatening situations while waiting for a clinical response or as a bridge to lung transplant. Conclusions: Thirteen recommendations regarding the treatment of the anti-MDA5 positive DM-RPILD were developed using research-based evidence and expert opinion. This project was supported by Spanish Rheumatology Society and Spanish Society of Internal Medicine (GEAS, Study Group on Autoimmune Diseases).
Databáze: OpenAIRE
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