ヤマナカ ヒサシ
  山中 寿
   所属   医学部 医学科(東京女子医科大学病院)
   職種   客員教授
論文種別 原著
言語種別 英語
査読の有無 査読なし
表題 Recent Treatment of Interstitial Lung Disease with Idiopathic Inflammatory Myopathies.
掲載誌名 正式名:Clinical medicine insights. Circulatory, respiratory and pulmonary medicine
略  称:Clin Med Insights Circ Respir Pulm Med
ISSNコード:(1179-5484)1179-5484(Linking)
掲載区分国外
巻・号・頁 9(Suppl 1),pp.9-17
著者・共著者 Kawasumi Hidenaga†, Gono Takahisa*, Kawaguchi Yasushi, Yamanaka Hisashi
発行年月 2015
概要 Interstitial lung disease (ILD) is a prognostic factor for poor outcome in polymyositis (PM)/dermatomyositis (DM). The appropriate management of ILD is very important to improve the prognosis of patients with PM/DM. ILD activity and severity depend on the disease subtype. Therefore, clinicians should determine therapeutic strategies according to the disease subtype in each patient with PM/DM. Anti-melanoma differentiation-associated gene 5 antibody and hyperferritinemia predict the development and severity of rapidly progressive (RP) ILD, particularly in East Asian patients. Combination therapy with corticosteroids, intravenous cyclophosphamide pulse, and calcineurin inhibitors should be administered in RP-ILD. In contrast, patients with anti-aminoacyl-tRNA synthetase (ARS) show better responses to corticosteroids alone. However, ILDs with anti-ARS often display disease recurrence or become refractory to corticosteroid monotherapy. Recent studies have demonstrated that the administration of tacrolimus or rituximab in addition to corticosteroids may be considered in ILD patients with anti-ARS. Large-scale, multicenter randomized clinical trials should be conducted in the future to confirm that the aforementioned agents exhibit efficacy in ILD patients with PM/DM. The pathophysiology of ILD with PM/DM should also be elucidated in greater detail to develop effective therapeutic strategies for patients with ILD in PM/DM.
DOI 10.4137/CCRPM.S23313
PMID 26279636