Topics:
Rheumatology • Interstitial lung disease • Pulmonology • Diffuse Parenchymal Lung Disease • Antifibrotic
When do you begin antifibrotic therapy for a patient with newly diagnosed ILD that is not IPF?
Do you base the decision on FEV1, 6MWD or symptoms at initial evaluation, or progression over time?
Answer from: at Academic Institution
The evidence behind starting anti-fibrotic therapy for non-IPF ILD is largely based on the results of the INBUILD trial where patients who have non-IPF ILD who demonstrate progression (based on at least a 10% decline in FVC or a 5% decline in FVC with worsening symptoms or radiologic progression) ha...
Sign in or Register to read more
Answer from: at Academic Institution
I appreciate and agree with Dr. @Ria Gripaldo's excellent answer and treatment approach.
It is important to recognize the INBUILD study had several restrictions which impact how its findings translate into routine clinical care, even though the study has provided notable information on the use of N...
Answer from: at Academic Institution
Typically I start antifibrotic therapy in a few situations:
The most common reason is ILD progression despite adequate immune suppression, defined as no extra-pulmonary disease activity (usually joint disease, but can tailor according to the patient's disease/situation, such as by presence of rash,...
Answer from: at Community Practice
This has been a very interesting and informative discussion on the use of antifibrotic therapy (essentially the FDA-approved Nintedanib) in patients with non-IPF ILD by rheumatologists and pulmonologists. I will restrict my comments to scleroderma patients with ILD (although I suspect there is to a ...