RT Journal Article
SR Electronic
T1 How consistently do physicians diagnose and manage drug-induced interstitial lung disease? Two surveys of European ILD specialist physicians
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00286-2019
DO 10.1183/23120541.00286-2019
VO 6
IS 1
A1 James A. Eaden
A1 Sarah Skeoch
A1 John C. Waterton
A1 Nazia Chaudhuri
A1 Stephen M. Bianchi
YR 2020
UL http://openres.ersjournals.com/content/6/1/00286-2019.abstract
AB Introduction Currently there are no general guidelines for diagnosis or management of suspected drug-induced (DI) interstitial lung disease (ILD). The objective was to survey a sample of current European practice in the diagnosis and management of DI-ILD, in the context of the prescribing information approved by regulatory authorities for 28 licenced drugs with a recognised risk of DI-ILD.Methods Consultant physicians working in specialist ILD centres across Europe were emailed two surveys via a website link. Initially, opinion was sought regarding various diagnostic and management options based on seven clinical ILD case vignettes and five general questions regarding DI-ILD. The second survey involved 29 statements regarding the diagnosis and management of DI-ILD, derived from the results of the first survey. Consensus agreement was defined as 75% or greater.Results When making a diagnosis of DI-ILD, the favoured investigations used (other than computed tomography) included pulmonary function tests, bronchoscopy and blood tests. The preferred method used to decide when to stop treatment was a pulmonary function test. In the second survey, the majority of the statements were accepted by the 33 respondents, with only four of 29 statements not achieving consensus when the responses “agree” and “strongly agree” were combined as one answer.Conclusion The two surveys provide guidance for clinicians regarding an approach to the diagnosis and management of DI-ILD in which the current evidence base is severely lacking, as demonstrated by the limited information provided by the manufacturers of the drugs associated with a high risk of DI-ILD that we reviewed.Two surveys illustrating current European practice in the diagnosis and management of drug-induced interstitial lung disease provide guidance for clinicians in a condition in which the present evidence base is lacking http://bit.ly/35A9YPk