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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Recommendations for the treatment of anti-melanoma differentiation-associated gene 5-positive dermatomyositis-associated rapidly progressive interstitial lung disease
Seminars in Arthritis and Rheumatism, Volume 50, No. 4, Year 2020
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Description
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. © 2020 Elsevier Inc.
Authors & Co-Authors
Romero-Bueno, Fredeswinda Isabel
Spain, Madrid
Universidad Autónoma de Madrid
Trallero-Araguás, Ernesto
Spain, Barcelona
Hospital Universitari Vall D'hebron
Sánchez-Pernaute, O.
Spain, Madrid
Universidad Autónoma de Madrid
González-Gay, Miguel Ángel
South Africa, Johannesburg
University of the Witwatersrand
Plana, M. N.
Spain, Madrid
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Selva-O'Callaghan, Albert
Spain, Barcelona
Hospital Universitari Vall D'hebron
Statistics
Citations: 101
Authors: 6
Affiliations: 12
Identifiers
Doi:
10.1016/j.semarthrit.2020.03.007
ISSN:
00490172
Research Areas
Genetics And Genomics
Health System And Policy