Table 3. Treatment strategies for AS specific ILD.

Medications	Suggested dose	Baseline testing	Test frequency	Major adverse effects
Corticosteroids	Prednisone: 1 mg/kg daily	Bone density	After 1 year, then every 2–3 years if stable or more frequently if bone density decreased	Hyperglycemia
	Upper limit: 60–80 mg daily	Hemoglobin A1c		Hypertension
				Osteoporosis
				Cataracts
				Sleep disturbances
Azathioprine	1.0–2.0 mg/kg/day	CBC, CMP, thiopurine S-methyltransferase (TPMT), pregnancy	Monthly, then every 3 months	BM suppression
				Hepatotoxicity, Pancreatitis
Mycophenolate	500–1,500 mg PO BID	CBC, CMP, pregnancy	Monthly, then every 3 months	BM suppression
				GI symptoms (e.g., diarrhea)
				Increase miscarriage & congenital abnormalities
Tacrolimus	1 mg twice daily (target trough levels 5–8 ng/mL)	CBC, CMP, pregnancy test	Monthly	CKD
				Hypertension
				Tremors
Cyclophosphamide	IV CYC monthly × 6 months	CBC, CMP, pregnancy, hepatitis panel, T-spot, urinalysis, age-appropriate cancer screening	Monthly ×1 year, then every 3 months	Malignancy, Cytopenias, Hemorrhagic cystitis, Sterility
Rituximab	1 gm × 2 doses, 2 weeks apart	CBC, CMP, HIV, hepatitis panel, T-spot test	Prior to each infusion	Infection, Neutropenia, Infusion reaction

AS, anti-synthetase syndrome; ILD, interstitial lung disease.