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Prevention and management of gastrointestinal side effects in patients with systemic sclerosis-interstitial lung disease receiving anti-fibrotic therapy: a modified Delphi consensus study - PubMed

7 hours ago
  • #interstitial lung disease
  • #gastrointestinal side effects
  • #systemic sclerosis
  • Interstitial lung disease (ILD) is common in systemic sclerosis (SSc) patients, often requiring immunosuppressive or anti-fibrotic therapy.
  • Gastrointestinal (GI) complications are prevalent in SSc-ILD patients, necessitating preventive measures and management strategies.
  • A modified Delphi study involving 20 rheumatologists from Italy achieved consensus on key recommendations.
  • Preliminary evaluation of GI status before anti-fibrotic therapy is essential (100% agreement).
  • Pre-existing conditions like diarrhea, weight loss, and nausea/loss of appetite should be considered (95-100% agreement).
  • Patients should be informed about potential GI complications and given nutritional advice (85-100% agreement).
  • Regular monitoring of GI status during therapy, ideally every 3 months, is recommended (75-100% agreement).
  • Dose reduction or temporary discontinuation of therapy may be needed for side effects like diarrhea or weight loss (85-95% agreement).
  • For nausea or loss of appetite, dose reduction is advised without immediate discontinuation (90% agreement).
  • Prospective validation is required to confirm the effectiveness of these recommendations.