Fast Five Quiz: Rheumatoid Arthritis Interstitial Lung Disease Management

Zab Mosenifar, MD


April 05, 2021

Though prospective, randomized clinical trials are needed, antifibrotic drugs may be an effective treatment option for patients with progressive fibrosing non-IPF-ILDs who have not responded to corticosteroids and immunosuppressive treatments. Pirfenidone and nintedanib are FDA-approved in the treatment of IPF and have been shown to reduce functional decline in patients with this form of disease. In particular, nintedanib secured approval for chronic fibrosing ILDs with a progressive phenotype in March 2020. Included in this category are unclassifiable ILDs, autoimmune ILDs, chronic hypersensitivity pneumonitis, sarcoidosis, myositis, Sjögren syndrome, and idiopathic forms of interstitial pneumonias (eg, idiopathic nonspecific interstitial pneumonia), which are all among the diseases that may develop a progressive form of chronic fibrosing ILD.

RA-ILD does typically progress faster in patients with UIP than those with other subtypes, but mortality rates vary. Most RA-ILD patients with UIP have a similar slightly improved prognosis compared with IPF, though notably acute exacerbations have a significant impact on survival.

Learn more about approach considerations in the treatment of CT-ILD.


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