From the Journals

Lung scan often not requested for new SSc patients

 

Key clinical point: Despite the risk of interstitial lung disease in systemic sclerosis patients, the use of high-resolution CT scans of the chest is inconsistent.

Major finding: Overall, 51% of ACR general rheumatologists and 66% of global systemic sclerosis experts ordered high-resolution CTs for new SSc patients.

Study details: The data come from surveys completed by 76 ACR general rheumatologists and 135 SSc experts worldwide.

Disclosures: The researchers had no financial conflicts to disclose. Dr. Bernstein was supported by a Rheumatology Research Foundation Scientist Development Award, and two of her colleagues were funded in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Heart, Lung, and Blood Institute.

Source: Bernstein E et al. Arthritis Rheumatol. 2018 Feb 9. doi: 10.1002/art.40441.


 

FROM ARTHRITIS & RHEUMATOLOGY

Only half of American general rheumatologists and two-thirds of global systemic sclerosis experts routinely request high-resolution CT chest scans for all their newly diagnosed systemic sclerosis patients despite their increased risk of interstitial lung disease, according to survey data from approximately 200 clinicians.

In a study published in Arthritis & Rheumatology, the researchers surveyed 676 American College of Rheumatology members and 356 global experts on systemic sclerosis; of these, 76 ACR general rheumatologists and 135 SSc experts responded. The use of high-resolution CT varied widely by country or region: 0 of 5 respondents from Australia, 2 of 6 from Canada, 28 of 47 from the United States, 45 of 57 from Europe, 4 of 5 from Asia, and 7 of 7 from Latin America.

The researchers also found little consensus on indications for high-resolution CT in SSc patients. Among the SSc experts who do not routinely obtain screening high-resolution CTs in their SSc patients, 81% said they would request one for dyspnea on exertion, 74% would request one for an abnormal forced vital capacity less than 80% of predicted, and 52% would request one for an abnormal diffusion capacity for carbon monoxide less than 80% predicted.

A significant limitation of the study was the low response rate, and more research is needed on the clinical impact of high-resolution CT screening for ILD in SSc patients, the researchers noted. However, the results highlight the need for a clinical practice guideline to create a more consistent approach to identifying ILD in these patients, they said.

The researchers had no financial conflicts to disclose. Dr. Bernstein was supported by a Rheumatology Research Foundation Scientist Development Award, and two of her colleagues were funded in part by the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Heart, Lung, and Blood Institute.

SOURCE: Bernstein E et al. Arthritis Rheumatol. 2018 Feb 9. doi: 10.1002/art.40441.

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