Screening, monitoring and treatment of interstitial lung disease in systemic sclerosis

Interstitial lung disease (ILD) is a major source of morbidity and the leading cause of mortality in people with systemic sclerosis (SSc). There have been advancements in the treatment of ILD. In this article, we review the American College of Rheumatology (ACR) and the American College of Chest Physicians (CHEST) guidelines for the screening, monitoring and treatment of SSc-ILD. We highlight additional pharmacologic and non-pharmacologic interventions that should be considered in those with SSc-ILD. Finally, we summarize the ACR guidelines for vaccinations in those with SSc-ILD, and recommendations for holding immunosuppressive therapies to maximize immunogenicity of the vaccines.