Interstitial lung disease progression after genomic usual interstitial pneumonia testing.

Autor:	Chaudhary S; Division of Pulmonary and Critical Care Medicine, University of Arizona, Tucson, AZ, USA., Weigt SS; Division of Pulmonary and Critical Care Medicine, University of California at Los Angeles, Los Angeles, CA, USA., Ribeiro Neto ML; Department of Pulmonary Medicine, Cleveland Clinic, Cleveland, OH, USA., Benn BS; Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA., Pugashetti JV; Division of Pulmonary, Critical Care and Sleep Medicine, University of California at Davis, Sacramento, CA, USA., Keith R; Division of Pulmonary and Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA., Chand A; Division of Pulmonary and Critical Care Medicine, University of Arizona, Tucson, AZ, USA., Oh S; Division of Pulmonary and Critical Care Medicine, University of California at Los Angeles, Los Angeles, CA, USA., Kheir F; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA., Ramalingam V; Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.; Northeast Georgia Physicians Group., Solomon JJ; Division of Pulmonary and Critical Care and Sleep Medicine, National Jewish Health, Denver, CO, USA., Harper R; Division of Pulmonary, Critical Care and Sleep Medicine, University of California at Davis, Sacramento, CA, USA., Lasky JA; Division of Pulmonary and Critical Care Medicine, Tulane University, New Orleans, LA, USA., Oldham JM; Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA oldhamj@med.umich.edu.; Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2023 Apr 01; Vol. 61 (4). Date of Electronic Publication: 2023 Apr 01 (Print Publication: 2023).
DOI:	10.1183/13993003.01245-2022
Abstrakt:	Background: A genomic classifier for usual interstitial pneumonia (gUIP) has been shown to predict histological UIP with high specificity, increasing diagnostic confidence for idiopathic pulmonary fibrosis (IPF). Whether those with positive gUIP classification exhibit a progressive, IPF-like phenotype remains unknown. Methods: A pooled, retrospective analysis of patients who underwent clinically indicated diagnostic bronchoscopy with gUIP testing at seven academic medical centres across the USA was performed. We assessed the association between gUIP classification and 18-month progression-free survival (PFS) using Cox proportional hazards regression. PFS was defined as the time from gUIP testing to death from any cause, lung transplant, ≥10% relative decline in forced vital capacity (FVC) or censoring at the time of last available FVC measure. Longitudinal change in FVC was then compared between gUIP classification groups using a joint regression model. Results: Of 238 consecutive patients who underwent gUIP testing, 192 had available follow-up data and were included in the analysis, including 104 with positive gUIP classification and 88 with negative classification. In multivariable analysis, positive gUIP classification was associated with reduced PFS (hazard ratio 1.58, 95% CI 0.86-2.92; p=0.14), but this did not reach statistical significance. Mean annual change in FVC was -101.8 mL (95% CI -142.7- -60.9 mL; p<0.001) for those with positive gUIP classification and -73.2 mL (95% CI -115.2- -31.1 mL; p<0.001) for those with negative classification (difference 28.7 mL, 95% CI -83.2-25.9 mL; p=0.30). Conclusions: gUIP classification was not associated with differential rates of PFS or longitudinal FVC decline in a multicentre interstitial lung disease cohort undergoing bronchoscopy as part of the diagnostic evaluation. Competing Interests: Conflict of interest: S. Chaudhary reports consulting fees from Veracyte and Boehringer Ingelheim, outside the submitted work. S.S. Weigt reports consulting fees from Vercyte, and lecture honoraria from Genentech/Roche and Boehringer Ingelheim, outside the submitted work. J.V. Pugashetti is a member of the American Thoracic Society Clinical Problems Planning Committee, outside the submitted work. R. Keith reports lecture honoraria from Envisia, outside the submitted work. S. Oh reports lecture honoraria from Veracyte, outside the submitted work. F. Kheir reports lecture honoraria from Veracyte, Biodesix and UpToDate, and leadership roles with the American College of Chest Physicians and Society of Advanced Bronchoscopy, outside the submitted work. J. Solomon reports grants from Boehringer Ingelheim, Pfizer and NIH, and lecture honoraria from Boehringer Ingelheim, outside the submitted work. J.A. Lasky reports lecture honoraria from Veracyte and Boehringer Ingelheim, advisory board participation with Galecto, United Therapeutics and Genentech, and acts as CMO of the Pulmonary Fibrosis Foundation, outside the submitted work. J.M. Oldham reports grants from the National Institutes of Health (K23HL138190); reports consulting fees from Boehringer Ingelheim, Lupin Pharmaceuticals, AmMax Bio, Roche and Veracyte, a patent “TOLLIP TT genotype for NAC use in IPF” issued, advisory board participation for Endeavor Biomedicines, and acts as Associate Editor for CHEST and Program Committee for the American Thoracic Society, outside the submitted work. All other authors have nothing to disclose. (Copyright ©The authors 2023. For reproduction rights and permissions contact permissions@ersnet.org.)
Databáze:	MEDLINE
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