Subject: Participation in the survey ‘An observational survey to evaluate management pattern of Hypersensitive Pneumonitis and the role of anti-fibrotics in Interstitial lung diseases.’
Hypersensitivity pneumonitis (HP) is a group of granulomatous, interstitial, bronchiolar, and alveolarfilling pulmonary diseases caused by repeated exposure and sensitization to a variety of organic and chemical antigens.1
HP has historically been treated with immunosuppressive medications, including mycophenolate and azathioprine, which have been shown to improve diffusing capacity in patients with HP. Rituximab has also been used in HP and in one retrospective study led to stabilization or improvement in pulmonary function testing in a subset of patients. Prednisone, while commonly used in the treatment of HP, has not been shown to reduce the decline in lung function in patients with HP.2
Establishing the diagnosis of HP is often challenging given its variable clinical course, extensive inciting agents, and overlapping features with other interstitial lung diseases. Recently, HP has been re-classified into nonfibrotic and fibrotic subtypes based on radiographic and histopathological features. Chronic fibrotic HP is associated with significant functional impairment and increased mortality. In addition to antigen avoidance, immunosuppression is the cornerstone of management in nonfibrotic HP. Antifibrotic agents have emerged as a therapeutic option in halting the progression of chronic fibrotic HP.3,4
Recently, Nintedanib has been approved for the treatment of progressive fibrotic HP based on the INBUILD trial In this trial, 26.1% of patients had HP (25.3% of the intervention group and 26.9% of the placebo group), and progressive fibrosis was defined as one or more of the following occurring in the 24 months before screening: a relative decline in forced vital capacity (FVC) of at least 10% predicted, a relative decline in FVC 5–10% predicted and either worsening of respiratory symptoms or an increased extent of fibrosis on high-resolution computed tomography (HRCT), or worsening of respiratory symptoms and an increased extent of fibrosis on HRCT.5
About 47.3% of patients with new-onset ILD in India were diagnosed with HP, the majority of whom were diagnosed as HP with a high level of confidence. The most common exposures were birds, cooling devices, and visible molds.6 There is limited data on the management of HP in Indian settings. Hence this study is planned to analyze the treatment pattern and role of anti-fibrotics in Hypersensitivity pneumonitis
We trust you and we are partners in providing safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for the accuracy of records.
|
}}){kind=logo}
}})