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CME: Frontiers in the treatment of systemic sclerosis interstitial lung disease: Therapeutic updates and best practices


Activity Description / Statement of Need:

In this online CME self-learning program: Systemic sclerosis (SSc) is a rare connective tissue disease that affects between eight and 56 people per million per year and up to 341 people per million total in the U.S., of whom around 70% will experience interstitial lung disease (ILD). The disease is characterized by a progressive course of scarring to the blood vessels underlying the skin, connective tissue, joints, and organs. The pathology of SSc remains to be fully elucidated, but different immunologic and genetic pathways have been explored as potential precipitating factors for SSc. Based on what is known, SSc-ILD may be summarized into three steps: 1) continuous injury to endothelial cells, 2) activation of innate and adaptive immunity, 3) recruitment and activation of fibroblasts. Early diagnosis is crucial for preservation and survival of major organs. Lung fibrosis is considered irreversible, and if the disease has progressed far beyond repair, lung transplantation is considered. Therefore, early detection is paramount in order for patients to preserve their lung function.

Target Audience:

The following HCPs: Pulmonologists, rheumatologists, radiologists, primary care physicians, dermatologists; physician assistants, nurse practitioners, nurses, and pharmacists specializing in pulmonology; and any other HCPs who have an interest in or otherwise clinically encounter patients with SSc-ILD.

This program is supported by an educational grant from Mallinckrodt Pharmaceuticals.

Learners may participate in this activity free of charge.

Release Date: October 08, 2020 -- Expiration Date: October 08, 2022

Faculty: Joseph Barney, M.D., MSPH FCCP


Faculty introduction, disclosures

Cursory refresher and review on SSc-ILD epidemiology and diagnosis

  • Pathophysiology: The connection between scleroderma and lung disease, types of scleroderma
  • Prevalence, underreporting, and risk factors
  • Clinical presentation and high-risk features

Assessment and diagnosis

o HRCT scan: Sensitivity and specificity

o Lung biopsy

  • Prognosis, mortality prediction, staging system

Treatment of SSc-ILD

  • Goals of therapy
  • Timing of treatment initation
  • Pharmacotherapy

o Corticosteroids, immunomodulators, cyclophosphamide

o Nintedanib

o Pirfenidone

  • Scleroderma

Extracorporeal photopheresis


  • Management of complications
  • Stem cell and lung transplantation

o Organ rejection

  • Patient education
  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Define the clinical features of systemic sclerosis.
  • Discuss current understanding of the biology of systemic sclerosis.
  • Define clinical phenotypes of systemic sclerosis.
  • Explore pulmonary manifestations of systemic sclerosis.
  • Understand the approach to diagnosis of systemic sclerosis interstitial lung disease and other pulmonary manifestations.


ACCME Activity #201861265


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure: Joseph Barney, MD, MSPH, FCCP, Associate Professor, University of Alabama at Birmingham, has no relevant conflicts of interest to disclose.

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, CEO of ScientiaCME, has no relevant conflicts of interest to disclose.

Disclosures of Peer Reviewers:
Joshua Mooney, MD, MS, has received financial compensation for research grants from Boehringer Ingelheim

Zaza Cohen, MD has no relevant conflicts of interest to disclose.

Commercial Support Disclosure: This program is supported by an educational grant from Mallinckrodt Pharmaceuticals.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

Additional Courses That Are Related To This Activity

Interstitial Lung Disease with Progressive Lung Disease Phenotype (ILD-PF): Therapeutic Updates, Best Practices, and Emerging Therapies

Systemic Sclerosis Interstitial Lung Disease (SSc-ILD): Optimizing Treatment Strategies

Employing biosimilars in the treatment of inflammatory health conditions: How to and should I?

Alpha-1 antitrypsin deficiency (AATD): Optimizing pharmacotherapeutic management strategies