From the Research
Treatment Options for Pulmonary Fibrosis Secondary to Scleroderma Overlapping with Rheumatoid Arthritis
- The treatment of interstitial lung disease (ILD) secondary to systemic sclerosis (SSc) and rheumatoid arthritis (RA) is complex and requires a multidisciplinary approach 1, 2, 3, 4, 5.
- There is no direct evidence to support the use of inhalers for the treatment of pulmonary fibrosis secondary to SSc overlapping with RA.
- However, studies have shown that disease-modifying antirheumatic drugs (DMARDs) such as abatacept, tocilizumab, and rituximab may be effective in slowing the worsening of ILD secondary to RA 2, 5.
- Non-anti-TNF biologic agents have been associated with slower worsening of ILD secondary to RA, and may be a suitable treatment option for patients with pulmonary fibrosis secondary to SSc overlapping with RA 5.
- The use of tyrosine kinase inhibitors such as nintedanib has also been approved for the treatment of SSc-ILD, and may be considered as a treatment option for patients with pulmonary fibrosis secondary to SSc overlapping with RA 4.
Management of Shortness of Breath (SOB) Attacks
- The management of SOB attacks in patients with pulmonary fibrosis secondary to SSc overlapping with RA requires a comprehensive approach that includes oxygen therapy, pulmonary rehabilitation, and pharmacological treatment 4.
- There is no specific evidence to support the use of inhalers for the treatment of SOB attacks in patients with pulmonary fibrosis secondary to SSc overlapping with RA.
- However, studies have shown that the use of oxygen therapy and pulmonary rehabilitation can improve symptoms and quality of life in patients with ILD secondary to RA 2, 5.
- The treatment of underlying inflammation and fibrosis with DMARDs and biologic agents may also help to reduce the frequency and severity of SOB attacks in patients with pulmonary fibrosis secondary to SSc overlapping with RA 2, 5.