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- Title
Clinical behaviour of patients exposed to organic dust and diagnosed with idiopathic pulmonary fibrosis.
- Authors
De Sadeleer, Laurens J.; Verleden, Stijn E.; De Dycker, Els; Yserbyt, Jonas; Verschakelen, Johny A.; Verbeken, Eric K.; Nemery, Benoit; Verleden, Geert M.; Hermans, Frederik; Vanaudenaerde, Bart M.; Wuyts, Wim A.
- Abstract
Background and objective: Although idiopathic pulmonary fibrosis (IPF) patients experience a worse survival compared with chronic hypersensitivity pneumonitis (CHP), organic dust exposure is a known risk factor for both IPF and CHP. Methods: We divided patients diagnosed with IPF, based on their exposure to moulds/birds (absent: group A; present: group B). We retrospectively compared pulmonary function and survival between groups A and B, and a separate CHP cohort (group C). Results: A total of 293 patients were included (group A: n = 171, group B: n = 73, group C: n = 49). Demographics and baseline pulmonary function did not differ between groups A and B, but significant differences were seen between groups B and C. Median survival of group B was 84 months, which was longer than group A (43 months, P = 0.002), but lower than group C (157 months, P = 0.04), in both univariate and multivariate analyses. Antifibrotic treatment resulted in a better outcome in group A (hazard ratio (HR): 0.44) and group B (HR: 0.12) without interaction between exposure and antifibrotic use (P = 0.20). Forced vital capacity (FVC) decline was not associated with mould/bird exposure in this cohort. Conclusion: Group B patients experienced a better outcome compared with (non‐exposed) IPF patients, although worse compared with CHP patients. Antifibrotic treatment in group B resulted in a similar beneficial effect compared with group A. Further research is needed to ascertain the diagnostic designation in this exposed usual interstitial pneumonia (UIP) patient group without other CHP features. Usual interstitial pneumonia (UIP) patients exposed to moulds or birds without other features of chronic hypersensitivity pneumonitis (CHP) experience a better survival compared with non‐exposed idiopathic pulmonary fibrosis (IPF) patients, although still worse compared with definite CHP patients. A similar beneficial effect from antifibrotics was seen irrespective of mould/bird exposure.
- Subjects
IDIOPATHIC pulmonary fibrosis; MICROBIOLOGICAL aerosols; DUST diseases; RESPIRATORY allergy; LUNG diseases; OBSTRUCTIVE lung diseases; RESPIRATORY obstructions
- Publication
Respirology, 2018, Vol 23, Issue 12, p1160
- ISSN
1323-7799
- Publication type
Article
- DOI
10.1111/resp.13342