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Semin Respir Crit Care Med 2024; 45(03): 342-364
DOI: 10.1055/s-0044-1786698
Review Article

Interstitial Lung Disease Associated with Systemic Sclerosis

Valentine Mismetti 
1   Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, ERN-LUNG, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
,
Salim Si-Mohamed 
2   INSA-Lyon, University of Lyon, University Claude-Bernard Lyon 1, Lyon, France
3   Radiology Department, Hospices Civils de Lyon, Lyon, France
,
Vincent Cottin 
1   Department of Respiratory Medicine, National Coordinating Reference Centre for Rare Pulmonary Diseases, ERN-LUNG, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
4   UMR 754, INRAE, Claude Bernard University Lyon 1, Lyon, France
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Abstract

Systemic sclerosis (SSc) is a rare autoimmune disease characterized by a tripod combining vasculopathy, fibrosis, and immune-mediated inflammatory processes. The prevalence of interstitial lung disease (ILD) in SSc varies according to the methods used to detect it, ranging from 25 to 95%. The fibrotic and vascular pulmonary manifestations of SSc, particularly ILD, are the main causes of morbidity and mortality, contributing to 35% of deaths. Although early trials were conducted with cyclophosphamide, more recent randomized controlled trials have been performed to assess the efficacy and tolerability of several medications, mostly mycophenolate, rituximab, tocilizumab, and nintedanib. Although many uncertainties remain, expert consensus is emerging to optimize the therapeutic management and to provide clinicians with evidence-based clinical practice guidelines for patients with SSc-ILD. This article provides an overview, in the light of the latest advances, of the available evidence for the diagnosis and management of SSc-ILD.

Keywords

interstitial lung disease - systemic sclerosis - SSc-ILD - fibrosis - immunosuppression - connective tissue diseases


Publication History

Article published online:
07 May 2024

© 2024. Thieme. All rights reserved.

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