RA-ILD Review

Team: RA-ILD Review, aka “Take Your Breath Away”

Base Article: Laria A, Lurati AM, Zizzo G, Zaccara E, Mazzocchi D, Re KA, Marrazza M, Faggioli P, Mazzone A. Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review. Front Med (Lausanne). 2022 May 13;9:837133. doi: 10.3389/fmed.2022.837133. PMID: 35646974; PMCID: PMC9136053.

Authors: University of South Florida Rheumatology Fellowship

  1. Caroline Bresnan, MD, Second-Year Rheumatology Fellow, University of South Florida
  2. Noor Bazerbashi, MD, First-Year Rheumatology Fellow, University of South Florida
  3. Joanne Valeriano, MD, Program Director, University of South Florida/James A. Haley VA
  4. Larry Young, MD, Rheumatology Section Chief, James A. Haley VA
  5. Loutfi Succari, MD, Assistant Program Director, University of South Florida
  6. Stacy Bagrova, MD, Rheumatology Attending, Clearwater, FL
  7. David Ying, MD, Rheumatology Attending, James A. Haley VA
  8. Alsayed Osman, MD, First-Year Rheumatology Fellow, University of South Florida
  9. Natasa Pejcic, MD, Second-Year Rheumatology Fellow, University of South Florida
  10. Tina Brar, MD, Rheumatology Attending, James A. Haley VA

Team Overview

Dealing with interstitial lung disease (ILD) in rheumatoid arthritis is like playing defense against Steph Curry. ILD has a major impact on morbidity and mortality, so all rheumatologists need to be on guard. This article took a three-point shot at breaking down the complexity of this topic in a very practical way – so practical that it proudly says “practical” in its title.

Identifying your opponent in medicine is as crucial as it is on the basketball court. This article describes the important differences between UIP and NSIP to help you decide if immunosuppression is the right move. Luckily, these days there are plenty of moves and multiple players when we talk about immunosuppression, and after reading this, you will have the knowledge to confidently choose your MVPs. Speaking of players, previously methotrexate was benched at the slightest hint of pulmonary disease, but this article challenges those early misconceptions and highlights the benefits of using it as a treatment. The paper even proposes an algorithm for when to keep methotrexate in play. Finally, the article gives guidance on when and how to monitor patients’ lung function to make sure your treatments are working.

Compared to some of the teams in the tournament, this article has a major advantage as a one-stop shop for managing ILD in RA patients, guiding us through screening, diagnosis, treatment, and monitoring in just one read. This paper provides a practical playbook for ILD with which you can devise the best strategy for your patients.

Want to learn more?

See the Q&A on theMednet.org about the following question: Do you generally recommend starting nintedanib prior to immunosuppressive therapy in a patient with CTD-ILD?

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