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A modified Delphi exercise in physician-perceived risk factors for drug-induced pneumotoxicity in patients with rheumatological disease
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 s12890-024-03287-0.pdf | Published version | 859.28 kB | Adobe PDF | View/Open |
| Title: | A modified Delphi exercise in physician-perceived risk factors for drug-induced pneumotoxicity in patients with rheumatological disease |
| Authors: | Cartlidge, MK Brown, KK Chaudhuri, N Corte, TJ Dieudé, P John, L Kelly, C Khanna, D McRorie, E Nicol, L Stewart, G Walsh, SLF Wijsenbeek, M Hirani, N Chalmers, GW Golla, J Hyldgaard, C Chaigne, B López Miguel, P Bendstrup, E Carbone, RG Selva-O’Callaghan, A Chaudhury, N Selvi, E Russell, T Ferreira, P Mukherjee, S Kah-Lai Leong, C Alfaro, T Carreira, PE Dhasmana, DJ Cameli, P Wuyts, WA Bennett, D Novelli, L Patel, DC Fahim, A Wilsher, ML Shifren, A Padilla, ML Muller, C Avdeev, S Dzhus, M Papanikolaou, IC Tanino, Y Fretheim, H Balbir-Gurman, A Vicens-Zygmunt, V Jones, MG Perch, M Brito de Araujo, D Conticini, E Keshavan, V Izumi, S Kalluri, M Hajari Case, A Turner, AM Baresic, M Koduri, GM Amaral, AF Eiger, G Salinas, M Nunes, MS Chai, GT Scarlata, S Radzikowska, E Maher, TM Benucci, M Myall, KJ Davidsen, JR Launay, D Culver, DEL Castro, HM Devi, HJG Naclerio, C Walker, UA Chua, F Garcia Gonzalez, E Montoya, SF Carty, SM Judge, EP O’Beirne, SL Johannson, KA Camus, P Bilaceroglu, S Gardiner, PV Nicol, LM Garcia Martos, Á Castillo, D Lipchik, RJ Drakopanagiotakis, F Vikse, J Ramirez, MTR Antin-Ozerkis, D Grainger, R Stewart, GA Borie, R Agrawal, A Ceribelli, A Guillen, A Saiton, S Tomii, K Luckhardt, T Highland, KB Gheorghiu, AM Kolb, M Cobilinschi, C Jones, RM Campainha, S Rosato, E Foti, R Juge, P-A Patil, S Busaid, NA Rednic, S Garzanova, L Solomon, JJ Kalyoncu, AF Ross, AD Perkovic, D Kabasakal, Y Mogulkoc, N Low, S-Y Godoy Spencer, LG Delobbe, A Toma, CL Hysa, E Reza Beiga, DM Waseda, Y MdC, V Parfrey, H Derrett-Smith, E Grazzini, S Ryerson, CJ Iudici, M Nossent, EJ Campochiaro, C Al-farttoosi, A Manfredi, A Robles-Perez, A Van der Lee, I Hirani, N Sulli, A Marovic, KF Saunders, P Bernardino, V Matsuda, T Rivera-Ortega, P Berlengiero, V Morovic-Vergles, J Kiyan, E Balestro, E Gabrielli, A Sebastiani, M Confalonieri, P Crestani, B Blum, HC Gudmundsson, G Crawshaw, A Robles-Perez, A Stebbings, SM Sehga, S Assaya, D Nunes, H |
| Item Type: | Journal Article |
| Abstract: | Background Drugs used to treat rheumatic disease are associated with pneumotoxicity (drug-induced lung disease), but little is known about associated risk factors. Aim To determine expert physician-perceived risk factors for developing pneumotoxicity in patients with rheumatologic conditions. Methods A modified international 3-tier Delphi exercise was performed. Tier 1 determined patient and drug variables that physicians perceive to be risk factors. Tier 2 determined degree of risk associated with the Tier-1 derived variables. Tier 3 aimed to internally validate and stratify exemplar cases into risk categories. Results 134 pulmonologists and 49 rheumatologists responded to Tier 1;157 physicians completed all tiers. Perceived risk factors included: drug type; history of previous pneumotoxicity; age; smoking; underlying rheumatic disease type and activity; renal function; pulmonary hypertension; left ventricular failure;presence, nature, severity and progression of pre-existing interstitial lung disease. Tier 2 data stratified these variables into risk profiles e.g. never versus current smoking was perceived as low and high risk respectively. An example of perceived high risk resulting from Tier 3 is a 75-year-old current smoker with high-activity rheumatoid arthritis (RA) with severe, progressive ILD being started on methotrexate. A perceived low risk is a 75-year-old currentsmoker with moderate-activity RA and emphysema with no cardiac or renal disease and no pre-existing ILD being started on rituximab. A risk prediction scoring tool is being developed to be used in validation studies. Conclusion This modified Delphi exercise defined and stratified the perceived risk factors for developing pneumotoxicity. Age, current smoking, high underlying rheumatological disease activity, HRCT definite UIP and honeycombing, severity and progression of pre-existing ILD were perceived to be the highest risk-factors. |
| Issue Date: | 31-Oct-2024 |
| Date of Acceptance: | 13-Sep-2024 |
| URI: | http://hdl.handle.net/10044/1/115880 |
| DOI: | 10.1186/s12890-024-03287-0 |
| ISSN: | 1471-2466 |
| Publisher: | BMC |
| Journal / Book Title: | BMC Pulmonary Medicine |
| Volume: | 24 |
| Copyright Statement: | © The Author(s) 2024 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
| Publication Status: | Published |
| Article Number: | 547 |
| Online Publication Date: | 2024-10-31 |
| Appears in Collections: | National Heart and Lung Institute Faculty of Medicine |
This item is licensed under a Creative Commons License
