New Directions Targeting Inflammatory and Fibrotic Pathways in the Management of SSc-ILD

Release Date: July 28, 2021
Last Reviewed: July 22, 2021
Expiration Date: July 28, 2022
Time to Complete Activity: 1.0 hour

*This activity expired for credit on July 28, 2022 and is no longer available for credit

Robert W. Hallowell, MD

Assistant Professor of Medicine 
Harvard Medical School
Director of the Interstitial Lung Disease Program
Pulmonary Clinic Director
Division of Pulmonary, Critical Care and Sleep Medicine 
Massachusetts General Hospital 
Boston, MA

Kristin B. Highland, MD
Director, Rheumatic Lung Disease Program
Cleveland Clinic 
Cleveland, OH

Elizabeth R. Volkmann, MD, MS
Assistant Professor of Medicine
Director, UCLA Scleroderma Program
Co-Director, UCLA CTD-ILD Program
Division of Rheumatology
Department of Medicine
University of California, Los Angeles 
David Geffen School of Medicine
Los Angeles, CA
This activity is provided by Paradigm Medical Communications, LLC.  

In collaboration with the Pulmonary Fibrosis Foundation.  

Disclosure of Commercial Support
This activity is supported by an educational grant from Genentech, a member of the Roche Group.  

Target Audience
This activity has been designed to address the educational needs of academic and community-based pulmonologists and rheumatologists. It may also benefit pathologists, radiologists, dermatologists, primary care physicians, nurse practitioners, PAs, pharmacists, nurses, residents, fellows, and other healthcare professionals involved in the care of patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD).

Statement of Need
Scleroderma or systemic sclerosis (SSc) is a rare autoimmune disorder characterized by fibrosis in the skin and internal organs, including the lungs, that results in increased morbidity and mortality for patients. SSc-ILD occurs in the majority of patients. Due to the rarity of the disease and the heterogeneity of symptoms, patients often experience diagnostic delay until referral to an appropriate specialist, thus delaying the opportunity for early treatment. For patients with risk factors for severe interstitial lung disease (ILD), rapid progression often occurs within the first 5 years from diagnosis. There is no curative treatment for SSc, but immunosuppressive agents, including the most recently approved, tocilizumab, and antifibrotics are available to delay the progression of SSc-ILD. Clinicians need to recognize the risk factors for severe SSc-ILD in patients with SSc and perform appropriate baseline testing and ongoing monitoring for ILD; patients presenting with symptoms of ILD need appropriate screening to make an appropriate diagnosis of SSc-ILD, so that therapy can be initiated. Data for the newest agents need to be disseminated and discussed by clinicians to establish the roles of these agents in the treatment of SSc-ILD. Clinicians in regions with centers of excellence need to stay up to date with rapidly emerging data, and clinicians in communities further removed from these centers need to be knowledgeable of SSc-ILD and centers of excellence to refer patients for cutting-edge care.

Learning Objectives
Upon completion of this activity, participants should be able to:

  • Assess patient risk factors for progressive SSc-ILD
  • Describe recommended monitoring for patients with scleroderma and SSc-ILD
  • Develop appropriate, evidence-based treatment plans for patients who have SSc-ILD
  • Summarize data on emerging agents for the treatment of SSc-ILD

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In accordance with ACCME requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in the activity. These relationships are described below. Any potential conflicts of interest have been resolved.

Robert W. Hallowell, MD
Consulting Fees: Boehringer Ingelheim Pharmaceuticals, Inc
Speakers Bureau: Boehringer Ingelheim Pharmaceuticals, Inc
Grant/Research Support: Boehringer Ingelheim Pharmaceuticals, Inc; Regeneron Pharmaceuticals, Inc

Kristin B. Highland, MD
Consulting Fees: Actelion Pharmaceuticals US, Inc.; Boehringer Ingelheim Pharmaceuticals, Inc; Genentech Inc.; United Therapeutics Corporation 
Speakers Bureau: Actelion Pharmaceuticals US, Inc.; Bayer Corporation; Janssen Pharmaceuticals, Inc
Grant/Research Support: Acceleron Pharma; Bayer Corporation; Boehringer Ingelheim Pharmaceuticals, Inc; Gossamer Bio, Inc.; Viela Bio, Inc. 

Elizabeth R. Volkmann, MD, MS
Consulting Fees: Boehringer Ingelheim Pharmaceuticals, Inc
Grant/Research Support: Corbus Pharmaceuticals Holdings, Inc.; Forbius (recently acquired by Bristol-Myers Squibb Company); Kadmon Holdings, Inc.

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Independent peer reviewer has no financial relationships to disclose.

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