Longitudinal Follow-up of Fibrosing Interstitial Pneumonia

Hwang, Jeong-Hwa; Misumi, Shigeki; Curran‐Everett, Douglas; Brown, Kevin K.; Şahin, Hakan; Lynch, David A.

doi:10.1097/rti.0b013e3181e35823

Cited by 31 publications

(6 citation statements)

References 31 publications

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“…H wang et al . [ 61 ] found that increasing honeycombing in patients with F-ILD on serial HRCT (in addition to the existence of honeycombing at baseline HRCT) over 1 year predicted mortality, although the same was not denoted by lung function measurements.…”

Section: Section 2: Prognostication and Monitoringmentioning

confidence: 99%

Progressive pulmonary fibrosis: an expert group consensus statement

Rajan

Cottin

Dhar³

et al. 2022

Eur Respir J

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This expert group consensus statement emphasises the need for standardising the definition of progressive fibrosing interstitial lung diseases (F-ILDs), with an accurate initial diagnosis being of paramount importance in ensuring appropriate initial management. Equally, case-by-case decisions on monitoring and management are essential, given the varying presentations of F-ILDs and the varying rates of progression. The value of diagnostic tests in risk stratification at presentation and, separately, the importance of a logical monitoring strategy, tailored to manage the risk of progression, are also stressed. The term “progressive pulmonary fibrosis” (PPF) exactly describes the entity that clinicians often face in practice. The importance of using antifibrotic therapy early in PPF (once initial management has failed to prevent progression) is increasingly supported by evidence. Artificial intelligence software for high-resolution computed tomography analysis, although an exciting tool for the future, awaits validation. Guidance is provided on pulmonary rehabilitation, oxygen and the use of non-invasive ventilation focused specifically on the needs of ILD patients with progressive disease. PPF should be differentiated from acute deterioration due to drug-induced lung toxicity or other forms of acute exacerbations. Referral criteria for a lung transplant are discussed and applied to patient needs in severe diseases where transplantation is not realistic, either due to access limitations or transplantation contraindications. In conclusion, expert group consensus guidance is provided on the diagnosis, treatment and monitoring of F-ILDs with specific focus on the recognition of PPF and the management of pulmonary fibrosis progressing despite initial management.

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Section: Section 2: Prognostication and Monitoringmentioning

confidence: 99%

Progressive pulmonary fibrosis: an expert group consensus statement

Rajan

Cottin

Dhar³

et al. 2022

Eur Respir J

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“…While a categorical FVC decline of ≥10% has been associated with an increased mortality risk in patients with IPF ( 16 – 19 ), CHP ( 20 – 22 ), and CTD-ILD ( 23 ), even modest FVC decline of≥5% decline has been linked to worse outcome in IPF ( 16 ). Baseline extent of fibrosis on high-resolution computed tomography (HRCT) has been linked to prognosis in different ILD subtypes ( 24 , 25 ), even in the absence of FVC decline ( 26 ), and suggests that longitudinal increase in fibrosis extent is a good measure of progressive ILD ( 25 , 27 , 28 ). Symptomatic worsening, either alone or in combination with FVC decline or fibrotic progression on HRCT also suggests ILD worsening, but has yet been to validated as a reliable predictor of outcome.…”

Section: The Pf-ild Phenotypementioning

confidence: 99%

Biomarkers in Progressive Fibrosing Interstitial Lung Disease: Optimizing Diagnosis, Prognosis, and Treatment Response

2021

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Interstitial lung disease (ILD) comprises a heterogenous group of diffuse lung disorders that commonly result in irreversible pulmonary fibrosis. While idiopathic pulmonary fibrosis (IPF) is the prototypical progressive fibrosing ILD (PF-ILD), a high proportion of patients with other ILD subtypes develop a PF-ILD phenotype. Evidence exists for shared pathobiology leading to progressive fibrosis, suggesting that biomarkers of disease activity may prove informative across the wide spectrum of ILDs. Biomarker investigation to date has identified a number of molecular markers that predict relevant ILD endpoints, including disease presence, prognosis, and/or treatment response. In this review, we provide an overview of potentially informative biomarkers in patients with ILD, including those suggestive of a PF-ILD phenotype. We highlight the recent genomic, transcriptomic, and proteomic investigations that identified these biomarkers and discuss the body compartments in which they are found, including the peripheral blood, airway, and lung parenchyma. Finally, we identify critical gaps in knowledge within the field of ILD biomarker research and propose steps to advance the field toward biomarker implementation.

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“…When comparing images side-by-side, it is important to ensure that equivalent anatomical slices are evaluated, especially when changes are marginal. Using such a simplified approach, Hwang et al [20] examined 72 patients with a variety of fibrotic interstitial lung diseases. They found 36% of patients showed HRCT worsening of fibrosis, with follow up CT at a median of 1 year from baseline.…”

Section: Computed Tomography and Progressive Phenotype Of Interstitia...mentioning

confidence: 99%

Thoracic computed tomography in the progressive fibrotic phenotype

Devaraj

Milanese

Sverzellati

2021

Current Opinion in Pulmonary Medicine

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Purpose of reviewTo discuss rationale and methods for determining progressive lung fibrosis on thoracic computed tomography (CT) and describe limitations and challengesRecent findingsIdentifying patients with progressive lung fibrosis is important to determine optimal treatment. Serial high-resolution computed tomography is a method of determining disease progression. A number of studies are reviewed in this article, that have explored various parameters (both visual and automated) that signify progressive fibrosis on CT.SummaryTo reliably use serial CT as a marker of disease progression in fibrotic lung disease, clinicians and radiologists need to be aware of the optimal methods for identifying changes in disease extent, and understand their limitations.

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Longitudinal Follow-up of Fibrosing Interstitial Pneumonia

Abstract: The extent of honeycombing at baseline and its progression on follow-up CT are important determinants of rate of survival in patients with fibrosing interstitial pneumonia.

Cited by 31 publications

References 31 publications

Progressive pulmonary fibrosis: an expert group consensus statement

Progressive pulmonary fibrosis: an expert group consensus statement

Biomarkers in Progressive Fibrosing Interstitial Lung Disease: Optimizing Diagnosis, Prognosis, and Treatment Response

Thoracic computed tomography in the progressive fibrotic phenotype

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