Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressive condition of unknown etiology. Both the tomographic patterns and the pathologic anatomy correspond to usual interstitial pneumonia (UIP). Unfortunately, this is an irreversible disease with a variable clinical course that involves different phenotypes. Some patients are stable for a long time, while others present frequent acute exacerbations, or suffer a rapid decline and die. Not long ago, most treatment options for IPF patients focused on inflammation and lung fibrosis, relying on antiinflammatories and immunosuppressants. However, results observed for steroid, azathioprine, and Nacetylcysteine therapies proved ineffective and were associated with increased mortality. During the last 3 years, our understanding of the underlying mechanisms of IPF pathogenesis has evolved remarkably. There is new evidence about the treatment of this disease. New trials have been published and are breaking new ground in the management of IPF patients. There are also numerous ongoing clinical trials studying potential targets related to IPF treatment. Keywords: Idiopathic pulmonary fibrosis, clinical trials, treatment.
Introduction: The oxygen saturation (SO2) can be measured using finger, ear or forehead sensors. The primary objective of this study was to evaluate the degree of agreement in the measurement of SO2 with different sensors (finger, ear and frontal) during six-minute walk test (6MWT) in patients with chronic obstructive pulmonary disease (COPD) and fibrosing interstitial lung diseases (f-ILD). Methodology: Observational and prospective study. SO2 measurements were made simultaneously with 3 sensors (finger-SO2-fg, ear-SO2-e, forehead reflectance-SO2-fh) at baseline, during and after the test (Nonin Wrist-Ox 3150).Result: 31 patients were evaluated (14 COPD, 17 f-ILD). The mean of age was 64.8, 54% women. BMI:24.6. FVC: 75.6%±17, FEV1: 64%±21. DLCO: 60%±20. 6MWT (m):436.9±97.The mean baseline SO2 was: SO2-fg 94.2% ± SD 1.96 (91-98%), SO2-fh 98.2% SD ± 1.82 (93%-100%) and SO2-e 98.2% ± SD 1.97 (93%-100%). The mean final SO2 was: SO2-fg86% ± SD 7.91 (69%-97%), SO2-fh 92% ± SD 8.87 (65%-100%) and SO2.e 91.8% ± SD 8.57 (67%-100%), The percentage of patients with O2 desaturation according to the type of sensor was: SO2-fg 74%, SO2-fh 61% and SO2-e 55%.The mean baseline SO2 difference between the sensors were: fg vs fh was -4.03% (95% CI: -4.62 to -3.43), fg vs e -3.96% (95% CI -4.64 to -3.29) and fh vs e -0.065 % (95% CI -0.39 to 0.52). The mean final SO2 difference between the fg vs fh was – 6.03% (95% CI -7.89 to -4.17), fg vs e -5.80% (95% CI -7.29 to -4.31), fh vs e -0.22 (95% CI -0.60 to -4.77). Conclusions: The fh/e sensors had SO2 readings had greater than the fg (baseline and at minute 6). A low degree of agreement was observed between the fg vs fh/e sensors.
Background: Real-world data on patients with autoimmune interstitial lung disease (Ai-ILD) is limited. Objectives: To describe baseline characteristics of patients with Ai-ILD in Argentina, including sociodemographic, clinical, serological, functional, and treatment features. Methods: EPIMAR 2 is a real-life, prospective, observational, multicenter registry of patients with Ai-ILD in Argentina, initiated in April 2022. Patients > 18 years old with Ai-ILD of ≤ 5 years were included and classified into three subgroups: ILD associated with connective tissue disease (CTD-ILD), interstitial pneumonia with autoimmune findings (IPAF), or ILD associated with antineutrophil cytoplasmic antibodies (ANCA-ILD). Results: 120 patients were included (73% women), with a median age of 58.6 years and a history of smoking in 65%. The subtypes were CTD-ILD (77%), IPAF (16%), and ANCA-ILD (7%). Among CTD subgroups, Systemic Sclerosis was the most prevalent (55%), followed by Rheumatoid Arthritis (31%). The most frequent serological data were antinuclear antibodies (75%), rheumatoid factor (39%), antiRo/SSa (22%), and antiCCP (15%). The most used treatments were glucocorticoids (75%), mycophenolate mofetil (44%), and methotrexate (32%). There were 41% of patients with subclinical ILD. Subclinical ILD had less functional impairment, with a median DLCO of 64% compared to 54% in symptomatic ILD. Conclusion: We report the first baseline data on patients with Ai-ILD in Argentina in EPIMAR 2 cohort. The CTD-ILD subgroup was predominant, and subclinical ILD had less functional impairment. A Multidisciplinary approach may explain the high proportion of subclinical ILD in this cohort.
Diffuse interstitial (or parenchymal) lung diseases (ILDs) are a very large group of diseases that although they share certain clinical features, have a very...