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. 2021 Sep;13(9):5556–5571. doi: 10.21037/jtd-20-3328

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.