open access

Vol 87, No 6 (2019)
ORIGINAL PAPERS
Published online: 2020-01-14
Submitted: 2019-11-19
Accepted: 2019-12-09
Get Citation

Diagnostic and treatment standards in idiopathic pulmonary fibrosis in the era of antifibrotic drugs in Poland: A real-world practice survey

Sebastian Majewski, Katarzyna Lewandowska, Magdalena Maria Martusewicz-Boros, Wojciech Jerzy Piotrowski
DOI: 10.5603/ARM.2019.0060
·
Pubmed: 31970724
·
Adv Respir Med 2019;87(6):221-230.

open access

Vol 87, No 6 (2019)
ORIGINAL PAPERS
Published online: 2020-01-14
Submitted: 2019-11-19
Accepted: 2019-12-09

Abstract

Background Currently, only two drugs have been shown to modify the inevitable natural history of idiopathic pulmonary fibrosis (IPF). Changes in the reimbursement policy for antifibrotic drugs in Poland have led to the availability of pirfenidone from January 2017 and nintedanib from March 2018 for the treatment of Polish patients with IPF. This study aimed to evaluate the possible changes and shortcomings in the clinical practice standards in IPF in the era of access to antifibrotic therapy in Poland. Methods A real-world data survey was performed among physicians attending the Polish Respiratory Society Congress held in May 2018. The present survey was a follow-up to the previous survey undertaken in 2016, before the availability of antifibrotics in Poland. Results A total of 99 physicians participated in the survey, among which 80% were pulmonologists. The majority of participants (83%) represented hospital-based clinicians and most of them (93%) were involved in interstitial lung diseases (ILD) management. As many as 63% of the respondents elaborate the final diagnosis of IPF working with the expert radiologist routinely, 47% do that in the cooperation with other pulmonologists, and if a biopsy was performed 39% discuss its results with the expert pathologist. Bronchoalveolar lavage (BAL) and surgical lung biopsy (SLB) would never be recommended in the differential diagnosis of IPF by 9% and 16% of the respondents, respectively. Corticosteroids (CS) or a combination of CS and immunosuppressants (IS) is still recommended by 22% of participants. Proton pump inhibitors (PPI) in the case of symptomatic GERD are prescribed by 44% of the respondents, and 12% prescribe PPI regardless of GERD symptoms. Pirfenidone is used by 70%, and nintedanib by 48% of the respondents. Only 39% of the respondents refer patients with IPF to professional rehabilitation centers. Conclusions The level of cooperation between pulmonologists and other specialists in the diagnostic workup of IPF is unsatisfactory. IPF treatment practices in the era of access to effective drugs in Poland require immediate improvement. There is an urgent need to develop the local Polish practical guidelines to improve the management of IPF.

Abstract

Background Currently, only two drugs have been shown to modify the inevitable natural history of idiopathic pulmonary fibrosis (IPF). Changes in the reimbursement policy for antifibrotic drugs in Poland have led to the availability of pirfenidone from January 2017 and nintedanib from March 2018 for the treatment of Polish patients with IPF. This study aimed to evaluate the possible changes and shortcomings in the clinical practice standards in IPF in the era of access to antifibrotic therapy in Poland. Methods A real-world data survey was performed among physicians attending the Polish Respiratory Society Congress held in May 2018. The present survey was a follow-up to the previous survey undertaken in 2016, before the availability of antifibrotics in Poland. Results A total of 99 physicians participated in the survey, among which 80% were pulmonologists. The majority of participants (83%) represented hospital-based clinicians and most of them (93%) were involved in interstitial lung diseases (ILD) management. As many as 63% of the respondents elaborate the final diagnosis of IPF working with the expert radiologist routinely, 47% do that in the cooperation with other pulmonologists, and if a biopsy was performed 39% discuss its results with the expert pathologist. Bronchoalveolar lavage (BAL) and surgical lung biopsy (SLB) would never be recommended in the differential diagnosis of IPF by 9% and 16% of the respondents, respectively. Corticosteroids (CS) or a combination of CS and immunosuppressants (IS) is still recommended by 22% of participants. Proton pump inhibitors (PPI) in the case of symptomatic GERD are prescribed by 44% of the respondents, and 12% prescribe PPI regardless of GERD symptoms. Pirfenidone is used by 70%, and nintedanib by 48% of the respondents. Only 39% of the respondents refer patients with IPF to professional rehabilitation centers. Conclusions The level of cooperation between pulmonologists and other specialists in the diagnostic workup of IPF is unsatisfactory. IPF treatment practices in the era of access to effective drugs in Poland require immediate improvement. There is an urgent need to develop the local Polish practical guidelines to improve the management of IPF.

Get Citation

Keywords

idiopathic pulmonary fibrosis; IPF; real-world data; clinical practice; diagnosis; treatment; Poland

About this article
Title

Diagnostic and treatment standards in idiopathic pulmonary fibrosis in the era of antifibrotic drugs in Poland: A real-world practice survey

Journal

Advances in Respiratory Medicine

Issue

Vol 87, No 6 (2019)

Pages

221-230

Published online

2020-01-14

DOI

10.5603/ARM.2019.0060

Pubmed

31970724

Bibliographic record

Adv Respir Med 2019;87(6):221-230.

Keywords

idiopathic pulmonary fibrosis
IPF
real-world data
clinical practice
diagnosis
treatment
Poland

Authors

Sebastian Majewski
Katarzyna Lewandowska
Magdalena Maria Martusewicz-Boros
Wojciech Jerzy Piotrowski

References (21)
  1. Raghu G, Remy-Jardin M, Myers JL, 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.
  2. Lederer DJ, Martinez FJ. Idiopathic pulmonary fibrosis. N Engl J Med. 2018; 378(19): 1811–1823.
  3. Ley B, Collard HR, King TE. Clinical course and prediction of survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2011; 183(4): 431–440.
  4. Raghu G, Rochwerg B, Zhang Y, et al. An official ATS/ERS/JRS/ALAT clinical practice guideline: treatment of idiopathic pulmonary fibrosis. An update of the 2011 clinical practice guideline. American Journal of Respiratory and Critical Care Medicine. 2015; 192(2): e3–e19.
  5. Richeldi L, du Bois RM, Raghu G, et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med. 2014; 370(22): 2071–2082.
  6. King TE, Bradford WZ, Castro-Bernardini S, et al. A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. N Engl J Med. 2014; 370(22): 2083–2092.
  7. Piotrowski WJ, Martusewicz-Boros MM, Białas AJ, et al. Idiopathic pulmonary fibrosis (IPF) — common practice in Poland before the "antifibrotic drugs era". Adv Respir Med. 2017; 85(3): 136–142.
  8. 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.
  9. Lodhi T, Hughes G, Stanel S, et al. Transbronchial lung cryobiopsy in idiopathic pulmonary fibrosis: a state of the art review. Adv Ther. 2019; 36(9): 2193–2204.
  10. Collard HR, Tino G, Noble PW, et al. Patient experiences with pulmonary fibrosis. Respir Med. 2007; 101(6): 1350–1354.
  11. Tomassetti S, Piciucchi S, Tantalocco P, et al. The multidisciplinary approach in the diagnosis of idiopathic pulmonary fibrosis: a patient case-based review. Eur Respir Rev. 2015; 24(135): 69–77.
  12. Walsh SLF. Multidisciplinary evaluation of interstitial lung diseases: current insights: Number 1 in the Series "Radiology" Edited by Nicola Sverzellati and Sujal Desai. Eur Respir Rev. 2017; 26(144).
  13. Cottin V, Bergot E, Bourdin A, et al. Adherence to guidelines in idiopathic pulmonary fibrosis: a follow-up national survey. ERJ Open Res. 2015; 1(2).
  14. Cottin V, Cadranel J, Crestani B, et al. Management of idiopathic pulmonary fibrosis in France: a survey of 1244 pulmonologists. Respir Med. 2014; 108(1): 195–202.
  15. Ghisa M, Marinelli C, Savarino V, et al. Idiopathic pulmonary fibrosis and GERD: links and risks. Ther Clin Risk Manag. 2019; 15: 1081–1093.
  16. Continuous or nocturnal oxygen therapy in hypoxemic chronic obstructive lung disease: a clinical trial. Nocturnal Oxygen Therapy Trial Group. Ann Intern Med. 1980; 93(3): 391–398.
  17. Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Report of the Medical Research Council Working Party. Lancet. 1981; 1(8222): 681–686.
  18. Dowman LM, McDonald CF, Bozinovski S, et al. Greater endurance capacity and improved dyspnoea with acute oxygen supplementation in idiopathic pulmonary fibrosis patients without resting hypoxaemia. Respirology. 2017; 22(5): 957–964.
  19. Nishiyama O, Kondoh Y, Kimura T, et al. Effects of pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis. Respirology. 2008; 13(3): 394–399.
  20. Dowman L, Hill CJ, Holland AE. Pulmonary rehabilitation for interstitial lung disease. Cochrane Database Syst Rev. 2014(10): CD006322.
  21. Laporta Hernandez R, Aguilar Perez M, Lázaro Carrasco MT, et al. Lung Transplantation in Idiopathic Pulmonary Fibrosis. Med Sci (Basel). 2018; 6(3).

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Pneumonologia i Alergologia Polska dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl