Diffuse Lung Disease & Interstitial Lung Disease Archives - PulmCCM
Advertisement


Diffuse Lung Disease & Interstitial Lung Disease Articles

Nov 222013
 
Idiopathic pulmonary fibrosis linked to herpesvirus infection

Is Idiopathic Pulmonary Fibrosis Caused by a Virus? The cause(s) of idiopathic pulmonary fibrosis have vexed researchers for decades. Although risk factors (smoking, familial gene mutations) provide clues, the actual trigger for the proliferative, fibrotic cellular process resulting in usual interstitial pneumonitis (on biopsy specimens) and IPF (clinically) have remained frustratingly elusive. But an exciting [... read more]

Oct 222013
 

A large phase III randomized trial testing Ambrisentan (Letairis) for early idiopathic pulmonary fibrosis was stopped early after an interim analysis of the data showed possible harm. The results were reported in Annals of Internal Medicine. Patients being treated with Letairis had more evidence of progression of idiopathic pulmonary fibrosis and were hospitalized more often, including [... read more]

Jul 102013
 
EUS / EBUS beat transbronchial biopsies for diagnosis of sarcoidosis in RCT

image: Olympus EUS / EBUS Superior at Diagnosing Sarcoidosis This post has been edited from the original to reflect a correction. It originally reported that this trial suggested EBUS alone was superior to transbronchial biopsy; see below. Sarcoidosis affects tens of thousands of people in the U.S., but making the diagnosis can be tricky. A [... read more]

Mar 312013
 
What works to help people with pulmonary fibrosis feel better? (Review)

Interventions to Improve Symptoms, Quality of Life in Fibrotic ILD: Do They Work? by Brett Ley, MD Patients with fibrotic interstitial lung diseases (e.g. idiopathic pulmonary fibrosis) have a poor overall prognosis, and there are no therapies proven to halt disease progression or extend life. Further, many of these patients have debilitating symptoms, limited functional [... read more]

Mar 202013
 
Bactrim for idiopathic pulmonary fibrosis? Intriguing, but not yet (RCT)

Bactrim/Septra for Idiopathic Pulmonary Fibrosis? by Brett Ley, MD Idiopathic pulmonary fibrosis (IPF) is a fatal fibrotic lung disease that lacks proven, effective treatments. Many novel medications have been trialed and painfully failed. So I commend Ludmila Shulgina and colleagues for trying an old medication, trimethoprim-sulfamethoxazole (TMP-SMX), with some preliminary evidence for potential benefit. What [... read more]

Jan 062013
 
PANTHER-IPF negative, stopped early for harm from steroids, Imuran in IPF (RCT)

(image: Wikipedia) As we reported a few months ago, the PANTHER-IPF trial was stopped early for safety, when it became clear that the combination of prednisone and azathioprine was hurting people with idiopathic pulmonary fibrosis (IPF). Ganesh Raghu (U-Washington), Kevin Anstrom (Duke), Talmadge King (UCSF) et al report the final results in the May 24 New [... read more]

Dec 262012
 
New IPF staging and prognosis model announced

(image: Wikipedia) Access the online GAP Score Calculator for IPF Although idiopathic pulmonary fibrosis (IPF) has a poor prognosis — a median survival of only 3 years — there is wide heterogeneity among individual patients. Some have a precipitous decline and die within months of diagnosis; others live for a decade or longer, with little [... read more]

Jul 272012
 
Idiopathic Pulmonary Fibrosis 2014 Update (Review)

Idiopathic Pulmonary Fibrosis (IPF) 2012 Review (More PulmCCM Topic Updates) This document is updated periodically as new research findings in IPF are published. What Causes IPF? (Etiology/Pathogenesis of IPF) Since it’s still called “idiopathic,” you probably figured out already that the cause(s) of IPF remain unknown. Researchers use a paradigm for studying idiopathic pulmonary fibrosis called [... read more]

Jul 232012
 
Hypersensitivity Pneumonitis Update (Review)

Hypersensitivity Pneumonitis 2012 Review (More PulmCCM Topic Updates) Hypersensitivity pneumonitis (external intrinsic alveolitis) is an “orphan disease,” which means it’s uncommon and lacks any likely way to effectively “monetize” the disease with drugs or device therapy, resulting in its being largely ignored from a research funding standpoint. If you think you don’t know much about [... read more]

Jul 212012
 
Black lung resurges in Appalachian coal country; mining co's not penalized (Ctr for Public Integrity)

In the 1950s, half of coal miners who worked 25 years contracted black lung, or coal workers pneumoconiosis. A 1969 federal law mandated dust controls in coal mines, and the incidence of black lung declined dramatically. But that was temporary. A new report by the Center for Public Integrity and National Public Radio shows that [... read more]

Mar 092012
 
Rituximab improved pulmonary alveolar proteinosis in pilot study (Eur Resp J)

Pulmonary alveolar proteinosis occurs as an idiopathic disease, or can be secondary to other conditions (HIV, silica exposure, infections, blood cancers). In the idiopathic form, autoantibodies to GM-CSF are thought to be responsible. Rituximab (a chimeric mouse-human monoclonal antibody binding CD-20) depletes human B-cells, reducing antibody production. Autoantibodies are particularly reduced after rituximab administration, leading [... read more]

Feb 182012
 

Please also see the newer post describing the final results of PANTHER-IPF, published in NEJM 2012. PANTHER-IPF, a landmark clinical trial testing commonly used therapies for idiopathic pulmonary fibrosis, was stopped in October 2011 for apparent harm caused to patients by prednisone and azathioprine. This news was released back then, but maybe you missed it, as [... read more]

Jan 012012
 

Air Travel for Patients with Lung Disease (BTS Recommendations) Some interesting facts, figures, and recommendations on air travel for those with chronic lung disease, thanks to Ahmedzai et al who produced this 32 page document for the British Thoracic Society: At 8,000 feet in a commercial aircraft, you’re breathing 15% O2, and normal people’s SpO2 [... read more]

Dec 262011
 

Noble et al report results of two Phase III placebo-controlled trials in N. America and Europe, with 779 patients total. In one trial, pirfenidone reduced FVC decline by ~4% at 72 weeks; in the other, it did not; pooling all the data, pirfenidone reduced FVC decline by 2.5% compared to placebo. There were abundant mild [... read more]

Nov 092011
 

Duke’s Momen Wahidi and other luminaries bring you a consensus statement on use of peri-procedure medications during bronchoscopy. I’m assuming you’ve done a few already, so here are some highlights (with slight liberties in paraphrasing): Use topical anesthesia as well as moderate sedation in all patients, unless there are contraindications or you practice at a secret CIA prison. [... read more]

Oct 232011
 

Talc pleurodesis is 90-95% effective at prevention of recurrent primary spontaneous pneumothorax. However, there have been reports of ARDS occurring after talc pleurodesis, mostly in patients with malignant pleural effusions, raising concerns over its use. Bridevaux et al report results of talc pleurodesis on 418 patients with primary spontaneous pneumothorax (PSP) at nine centers in Europe and [... read more]

Oct 222011
 

Is bronchoalveolar lavage useful in the diagnosis and management of interstitial lung disease? Meyer and Raghu believe so (although their manuscript title suggests they’re not 100% sure). They explain why in the October ERJ. They argue that if interpreted in the right clinical context, certain bronchoalveolar lavage findings can help cinch the diagnosis of ILD: Lymphocytes >= 25%: [... read more]

Sep 222011
 

Lung fibrosis is partially mediated by tyrosine kinase pathways. BIBF 1120 is a tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor (VEGFR), fibroblast growth factor receptor (FGFR) and platelet-derived growth factor receptor (PDGFR) — all receptors known to be involved in lung fibrosis. Supported by Boehringer Ingelheim, Richeldi et al randomized 432 patients with [... read more]