Effect of Nintedanib in Subgroups of Idiopathic Pulmonary Fibrosis by Diagnostic Criteria

Raghu, Ganesh; Wells, Athol U.; Nicholson, Andrew G.; Richeldi, Luca; Flaherty, Kevin R.; Maulf, Florence Le; Stowasser, Susanne; Schlenker‐Herceg, Rozsa; Hansell, David M.

doi:10.1164/rccm.201602-0402oc

Cited by 156 publications

(122 citation statements)

References 21 publications

(31 reference statements)

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“…Standard approach to ATT-DIH is to stop INH if ALT raises at least 3 fold over UNL along with jaundice and/or symptoms of hepatic illness. In absence of symptoms ALT rise 5 times is deciding factor [50] . When ALT does not recover following ATT withdrawal, detailed investigations for autoimmune disease are indicated.…”

Section: Conclusion and Epiloguementioning

confidence: 99%

Liver Dysfunction in Pulmonary Tuberculosis Patients on DOTS: A Study and Review

Pandit

Pandey

2016

Journal of Gastroenterology and Hepatology Research

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eGFR were done. Development of hepatotoxicity was watched by monthly monitoring of liver enzymes and bilirubin serum profiles. RESULT: The selected 148 patients were older and four fifths were males. 16 patients developed ATT-DIH at first or second month monitoring following DOTS. They were more undernourished, hypoproteinaemic, bore more extensive disease and were sputum AFB positive. Their eGFR profiles were normal but significantly lower and plasma antioxidant capacity significantly reduced. Oxidative stress marker levels also were insignificantly raised. They exhibited subclinical elevation of serum enzymes AST and ALT. No significant influence of age and gender was seen on incidence of ATT-DIH. CONCLUSION: Frailty with extensive disease constituted phenotype vulnerable to ATT-DIH. Hypoalbuminaemia, reduced plasma antioxidant capacity, subclinical elevated profile of transaminases before starting DOTS were forewarning laboratory indices. LFT ought to be monitored at fortnight, a month and at 2 months in such patients as minimum necessity to timely detect and address hepatotoxicity. INTRODUCTIONTuberculosis continues as huge health care problem globally. Currently recommended first line treatment for TB includes regimen of isoniazid (INH), rifampicin (RMP), pyrazinamide (PZA) and ethambutol (EMB) for initial 2 months followed by 4 months of INH and RMP and/or EMB [1] . Among the first line quadruple therapy drugs (INH, RMP, PZA, EMB), first three are metabolized mainly by the liver and are potentially hepatotoxic. A fair fraction of TB patients on chemotherapy with isoniazide and rifampicin exhibit elevations in serum levels of liver enzymes, alanine aminotransferase (ALT, earlier called SGPT) and aspartate aminotransferase (AST, earlier SGOT) activities. A small fraction of these can worsen further to compel ABSTRACT CONTEXT: Phenomenal number of people suffers tuberculosis and is prescribed primary line DOTS antitubercular chemotherapy. Evidence based clinical practice to minimize risk of hepatotoxicity is primary imperative. AIM: Study generates evidence for predicting individual hepatotoxic risk using patient's constitutional and health parameters and disease characteristics and adopting right course of management. It is observational study in patients consecutively selected by defined inclusion and exclusion criteria. METHODS: Newly enrolled pulmonary tuberculosis patients for DOTS were studied to examine host and disease specific predictors of hepatotoxicity risk. Pretreatment baseline liver function tests and

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Section: Conclusion and Epiloguementioning

confidence: 99%

Liver Dysfunction in Pulmonary Tuberculosis Patients on DOTS: A Study and Review

Pandit

Pandey

2016

Journal of Gastroenterology and Hepatology Research

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“…Therefore, when we see IPF with inflammation component, pirfenidone is an option. In progressive deteriorating group, first three months trend of vital capacity is predictive of mortality (71 …”

Section: Real Managementmentioning

confidence: 99%

Staging of idiopathic pulmonary fibrosis

Kishaba¹

2017

Int j curr adv res

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“…Recent articles support that the possible UIP pattern likely represents an early UIP pattern. 18,19 Features that would suggest an alternative diagnosis include consolidation as can be seen in organizing pneumonia (Figure 3), air trapping that is seen in hypersensitivity pneumonitis, and nodules, which are also seen in hypersensitivity pneumonitis and sarcoidosis. Ground glass opacities are frequently seen in patients with desquamative interstitial pneumonitis or respiratory bronchiolitis interstitial lung disease.…”

Section: Radiologymentioning

confidence: 99%