The interstitial lung disease multidisciplinary meeting: A position statement from the Thoracic Society of Australia and New Zealand and the Lung Foundation Australia

Prasad, Jyotika D; Mahar, Annabelle; Bleasel, Jane; Ellis, Samantha; Chambers, Daniel C.; Lake, Fiona; Hopkins, Peter; Corte, Tamera J.; Allan, Heather; Glaspole, Ian

doi:10.1111/resp.13163

Cited by 48 publications

(55 citation statements)

References 74 publications

(172 reference statements)

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“…Other fibrosing ILD including CTD‐ILD, cHP and asbestosis can also present with a UIP pattern on HRCT and/or histopathology and thus may incorrectly be diagnosed as IPF. Given that treatment of these conditions differs considerably from IPF, it is crucial that any patient with a fibrosing ILD undergo a thorough assessment including a detailed history of environmental exposures as well as specific questioning for subtle symptoms and signs of a CTD . Evaluation of autoantibodies as well as serum precipitins should also be considered in a compatible clinical context .…”

Section: Pharmacological Therapymentioning

confidence: 99%

Treatment of idiopathic pulmonary fibrosis in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand and the Lung Foundation Australia

Troy

Keir

et al. 2017

Respirology

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Idiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial lung disease (ILD) of unknown aetiology with a median survival of only 2-5 years. It is characterized by progressive dyspnoea and worsening lung function, ultimately resulting in death. Until recently, there were no effective therapies for IPF; however, with the publication of two landmark clinical trials in 2014, the anti-fibrotic therapies, nintedanib and pirfenidone, have gained widespread approval. This position paper aims to highlight the current evidence for the treatment of IPF, with particular application to the Australian and New Zealand population. We also consider areas in which evidence is currently lacking, especially with regard to the broader IPF severity spectrum and treatment of co-morbid conditions. The utility of non-pharmacological therapies including pulmonary rehabilitation, oxygen as well as symptom management thought to be important in the holistic care of IPF patients are also discussed.

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Section: Pharmacological Therapymentioning

confidence: 99%

Treatment of idiopathic pulmonary fibrosis in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand and the Lung Foundation Australia

Troy

Keir

et al. 2017

Respirology

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“…16 A multidisciplinary approach to ILDs, including IPAF, increases the likelihood of obtaining an accurate diagnosis for optimal treatment and prognostic definition, reducing the frequency of unclassifiable diagnoses. 16,38 In current practice, a multidisciplinary discussion is necessary to determine whether a patient fulfills the criteria for IPAF; however, IPAF is a research statement, 15 and for now this terminology should not be used in pathologic conclusions. In our practice, some commentaries with recommendations for the investigation of possible underlying autoimmune process are added to the pathologic reports.…”

Section: Role Of Multidisciplinary Discussion In Ipaf Classificationmentioning

confidence: 99%

Morphologic Aspects of Interstitial Pneumonia With Autoimmune Features

Nascimento

Baldi

Sawamura

et al. 2018

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Interstitial lung disease, a common complication observed in several connective tissue diseases, causes significant morbidity and mortality. Similar to individuals with connective tissue diseases, a significant subgroup of patients with clinical and serologic characteristics suggestive of autoimmunity but without confirmed specific connective tissue disease presents with associated interstitial lung disease. These patients have been classified using different controversial nomenclatures, such as undifferentiated connective tissue disease–associated interstitial lung disease, lung-dominant connective tissue disease, and autoimmune featured interstitial lung disease. The need for a better understanding and standardization of this entity, interstitial lung disease with autoimmune features, and the need for an adequate management protocol for patients resulted in the introduction of a new terminology in 2015: interstitial pneumonia with autoimmune features. This new classification requires a better comprehension of its diagnostic impact and the influence of its morphologic aspects on the prognosis of patients. Objective.— To review the diagnostic criteria for interstitial pneumonia with autoimmune features, with an emphasis on morphologic aspects. Data Sources.— The review is based on the available literature, and on pathologic, radiologic, and clinical experience. Conclusions.— The interstitial pneumonia with autoimmune features classification seems to identify a distinct subgroup of patients with different prognoses. Studies show that nonspecific interstitial pneumonia and usual interstitial pneumonia are the most prevalent morphologic patterns and show discrepant results on the impact of the usual interstitial pneumonia pattern on survival. Prospective investigations are necessary to better define this subgroup and to determine the prognosis and appropriate clinical management of these patients.

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“…Expert ILD multidisciplinary meetings may display considerable heterogeneity in final diagnoses 18 , 22 . To achieve standardisation, based on relatively limited and evolving data supplemented by expert opinion, we have produced a statement 10 outlining the conduct of the multidisciplinary meeting regarding core clinical input, discussion and diagnostic outputs.…”

Section: Diagnosismentioning

confidence: 99%

“…This article summarises two recently published position statements from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia, outlining the diagnosis 10 and treatment of IPF 11 . They do not represent guidelines per se but are based on current evidence as well as expert opinion.…”

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confidence: 99%

Diagnosis and management of idiopathic pulmonary fibrosis: Thoracic Society of Australia and New Zealand and Lung Foundation Australia position statements summary

Prasad

Troy

et al. 2017

Medical Journal of Australia

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Idiopathic pulmonary fibrosis (IPF) is a fibrosing interstitial lung disease associated with debilitating symptoms of dyspnoea and cough, resulting in respiratory failure, impaired quality of life and ultimately death. Diagnosing IPF can be challenging, as it often shares many features with other interstitial lung diseases. In this article, we summarise recent joint position statements on the diagnosis and management of IPF from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia, specifically tailored for physicians across Australia and New Zealand. Main suggestions: A comprehensive multidisciplinary team meeting is suggested to establish a prompt and precise IPF diagnosis. Antifibrotic therapies should be considered to slow disease progression. However, enthusiasm should be tempered by the lack of evidence in many IPF subgroups, particularly the broader disease severity spectrum. Non-pharmacological interventions including pulmonary rehabilitation, supplemental oxygen, appropriate treatment of comorbidities and disease-related symptoms remain crucial to optimal management. Despite recent advances, IPF remains a fatal disease and suitable patients should be referred for lung transplantation assessment.

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The interstitial lung disease multidisciplinary meeting: A position statement from the Thoracic Society of Australia and New Zealand and the Lung Foundation Australia

Cited by 48 publications

References 74 publications

Treatment of idiopathic pulmonary fibrosis in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand and the Lung Foundation Australia

Treatment of idiopathic pulmonary fibrosis in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand and the Lung Foundation Australia

Morphologic Aspects of Interstitial Pneumonia With Autoimmune Features

Diagnosis and management of idiopathic pulmonary fibrosis: Thoracic Society of Australia and New Zealand and Lung Foundation Australia position statements summary

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