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Thank you very much for your interest in our article ‘Prediction of progression of interstitial lung disease in patients with systemic sclerosis: the SPAR model’1 and your precious questions ‘Can we further SPARkle the SPAR model’.2 We are glad to respond as below.
Ever having arthritis and progression of ILD
Musculoskeletal manifestations in scleroderma are commonly treated with methotrexate. The progress/worsening of ILD by methotrexate has been widely contested across various disease groups. Hence, could it be possible that the subset of patients with arthritis ended up receiving methotrexate, which in turn was responsible for ILD progression?
The causative role of methotrexate (MTX) in inducing or exacerbating interstitial lung disease (ILD) is quite controversial, especially in non-rheumatoid arthritis autoimmune diseases.3 Furthermore, Avouac et al 4 reported that the presence of joint synovitis was an independent predictor for disease progression in systemic sclerosis (SSc), suggesting that arthritis by itself is associated with organ manifestations independent …
Handling editor Josef S Smolen
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Commissioned; internally peer reviewed.
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