Evaluation of patients with fibrotic interstitial lung disease: A Canadian Thoracic Society position statement

Outcomes Following Surgical Lung Biopsy for Interstitial Lung Diseases: A Monocenter Experience

“…Over the last decades, the diagnostic algorithm of ILD has evolved with an increased reliance on HRCT and MDD for a final diagnosis. [4][5][6][8][9][10][11][12][13][14][15]17 Nonetheless, a subset of patients remains with unclassifiable ILD for which SLB is still regarded as the gold standard for obtaining pathologic assessment and a final diagnosis. In this context, the decision regarding whether or not to undergo a SLB is tailored according to the individual risks of SLB and the potential benefit of obtaining a confident diagnosis guiding subsequent treatments.…”

Triaging Access to Critical Care Resources in Patients With Chronic Respiratory Diseases in the Event of a Major COVID-19 Surge

“… 8 Our criteria were derived from literature describing long-term IPF outcomes, predisposing factors, and clinical course of AE-IPF, and risk of poor outcomes after surgical lung biopsy. 9 , 10 Because we could not identify clear criteria for >50% predicted mortality (level 2), we reiterated criteria for >80% predicted mortality (level 1). Level 3 criteria were validated in the sex, age, physiology model, predicting a relatively low probability of 1-year mortality.…”

Comprehensive management of fibrotic interstitial lung diseases: A Canadian Thoracic Society position statement

“…Deciding on the most appropriate pharmacotherapy for fibrotic ILD requires an accurate diagnosis. 2 Pirfenidone and nintedanib are approved in Canada for the treatment of IPF and both anti-fibrotic medications have been recommended for the management of IPF in recent international guidelines. 3 Pirfenidone is a nonspecific anti-fibrotic agent thought to act on multiple targets along the fibrotic cascade.…”

“…Importantly, immunosuppressive medications have potential to cause harm in patients with IPF, 14 emphasizing the importance of establishing the correct diagnosis in patients with fibrotic ILD. 2 Referral to a tertiary care center for enrollment in clinical trials can be considered in selected cases of fibrotic ILD.…”

“…1 The diagnosis of fibrotic ILD is challenging, with key diagnostic considerations described and recommendations provided in a recent Canadian Thoracic Society (CTS) Position Statement. 2 The management of patients with ILD is also complex and must be multi-faceted, including pharmacological and non-pharmacological therapies.…”