Immunosuppressive therapy for autoimmune lung diseases.

This article focuses on issues of safety and monitoring when immunosuppressive pharmacologic therapies are prescribed for the treatment of connective tissue disease (CTD)-associated interstitial pneumonias, vasculitides, and bronchiolitis. Prospective, randomized placebo-controlled clinical trials have yet to be performed to evaluate the efficacy and safety of various immunosuppressive agents used to treat patients with CTD-interstitial lung disease or idiopathic interstitial pneumonias other than idiopathic pulmonary fibrosis (idiopathic usual interstitial pneumonia) that are not associated with the presence of CTD. Knowledge of their potential toxicities and interactions with other drugs combined with the adoption of a systematic approach to monitoring therapy can minimize life-threatening reactions.