IPF IS A DEBILITATING LUNG DISEASE.1

  • IPF is a progressive, fatal disease that typically affects adults over 60 years of age,2 with a median survival of 3.8 years from diagnosis, generally the shortest of all ILDs3,a
  • IPF is more common in men than women3
  • Most patients with IPF have a history of cigarette smoking2,4
  • Most patients experience a progressive decline, though the disease course is variable4
  • As fibrosis progresses, patients will become more breathless, less mobile, and less independent5
  • Patients may experience periods of sudden respiratory decline termed acute exacerbations of IPF,6 which are associated with a high mortality rate7-9
  • Symptoms are nonspecific, but patients often present with chronic exertional dyspnea and a dry, nonproductive cough6
    • The average time from symptom onset to diagnosis is 1-2 years10-12
  • Diagnosis of IPF is difficult, often requiring discussion between pulmonologists, radiologists, and pathologists6,13
    • Diagnosis requires a comprehensive patient evaluation including a detailed medical history, exclusion of other possible causes of lung disease, pulmonary function testing, HRCT, and in some cases, surgical lung biopsy6
  • Comprehensive care includes disease-focused, symptom-focused, and support-focused management14

ªIn the Medicare population

REFERENCES

  1. Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733-748. doi:10.1164/rccm.201308-1483ST.
  2. Raghu G, Remy-Jardin M, Myers JL, et al. Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2018;198(5):e44-e68. doi: 10.1164/rccm.201807-1255ST.
  3. Raghu G, Chen S-Y, Yeh W-S, et al. Idiopathic pulmonary fibrosis in US Medicare beneficiaries aged 65 years and older: incidence, prevalence, and survival, 2001-11. Lancet Respir Med. 2014;2(7):566-572. doi: 10.1016/S2213-2600(14)70101-8.
  4. Raghu G, Collard HR, Egan JJ, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management . Am J Respir Crit Care Med. 2011;183(6):788-824. doi: 10.1164/rccm.2009-040GL.
  5. Swigris JJ, Stewart AL, Gould MK, et al. Patients' perspectives on how idiopathic pulmonary fibrosis affects the quality of their lives. Health Qual Life Outcomes. 2005;3:61. doi: 10.1186/1477-7525-3-61.
  6. Raghu G, Weycker D, Edelsberg J, Bradford WZ, Os-ter G. Incidence and prevalence of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2006;174(7):810-816. doi:10.1164/rccm.200602-163OC.
  7. Kubo H, Nakayama K, Yanai M, et al. Anticoagulant therapy for idiopathic pulmonary fibrosis. Chest. 2005;128(3):1475-1482. doi: 10.1378/chest.128.3.1475.
  8. Kim DS, Park JH, Park BK, et al. Acute exacerbation of idiopathic pulmonary fibrosis: frequency and clinical features. Eur Respir J. 2006;27(1):143-150. doi: 10.1183/09031936.06.00114004.
  9. Daniels CE, Yi ES, Ryu JH. Autopsy findings in 42 consecutive patients with idiopathic pulmonary fibrosis. Eur Respir J. 2008;32:170-174. doi: 10.1183/09031936.00176307.
  10. Ley B, Collard HR, King TE Jr. Clinical course and prediction of survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2011;183(4):431-440. doi:10.1164/rccm.201006-0894CI.
  11. King TE, Schwarz MI, Brown K, et al. Idiopathic pulmonary fibrosis: relationship between histopathologic features and mortality. Am J Respir Crit Care Med. 2001;164(6):1025-1032. doi: 10.1164/ajrccm.164.6.2001056.
  12. Jegal Y, Kim DS, Shim TS, et al. Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia. Am J Respir Crit Care Med. 2005;171(6):639-644. doi: 10.1164/rccm.200403-331OC.
  13. Flaherty KR, King TE, Raghu G, et al. Idiopathic interstitial pneumonia: what is the effect of a multidisciplinary approach to diagnosis?. Am J Respir Crit Care Med. 2004;170(8):904-910. doi: 10.1164/rccm.200402-147OC.
  14. Lee JS, McLaughlin S, Collard HR. Comprehensive care of the patient with idiopathic pulmonary fibrosis. Curr Opin Pulm Med. 2011;17(5):348-354. doi: 10.1097/MCP.0b013e328349721b.

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