Date: {{$ActivityAssignDate}}

Dear Dr. {{ $doctorName }},

Subject : An observational survey to evaluate management pattern of Connective tissue disorder associated ILD and to understand the role of anti-fibrotics

Interstitial lung disease (ILD) is a common manifestation of connective tissue diseases (CTDs). • ILD can be seen in all CTDs but most commonly in rheumatoid arthritis (RA), systemic sclerosis (SSc), and idiopathic inflammatory myopathy (IIM). In RA, Lung involvement (i.e. parenchymal, pleural, and airway) is seen in 60 to 80% of patients, though a significant number of these cases are either subclinical (no associated symptoms) or not clinically significant (not contributing to death or disability). ILD prevalence in unselected subjects ranges from 19 to 67% depending on the modality of diagnosis. The 3-year cumulative incidence is 6.8% and the lifetime risk is 7.7%. > Lung involvement may pre-date the joint disease in up to 20% of subjects. Though the incidence appears stable, the prevalence and death from ILD among decedents with RA are on the rise. • In SSc, the overall incidence globally ranges from 8 to 56 new cases per million persons per year, and the prevalence rates are between 38 and 341 cases per million persons. ILD is generally thought to be more prevalent in patients with diffuse SSc than with limited SSc though both subsets can develop ILD. The incidence of IIMs is 1-19 cases per million persons per year, and prevalence is approximately 1 per 100,000. The prevalence of ILD in this population varies based on criteria (HRCT vs. physiologic screening) and ranges from 9-78%. In 10-30% of patients, ILD can be the first manifestation and precede the diagnosis of autoimmune disease by several years. ILD also occurs in patients with other CTDs including Sjögren’s syndrome, systemic lupus erythematosus, and mixed connective tissue disease.i

There is limited real-world data available on usage of anti-fibrotics in connective tissue associated interstitial diseases in India. Therefore, this multicentric survey is designed to understand the same.