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Prevalence of Airway Disease in Patients with Idiopathic Pulmonary Fibrosis
Description
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A1592 - Prevalence of Airway Disease in Patients with Idiopathic Pulmonary Fibrosis
Author Block: P. Hee Moon, J. Lee, Y. Park, C. Lee, S. Lee, J. Yim, C. Yoo, Y. Kim, S. K. Han, S. Choi; Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of.
RATIONALE
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial pneumonia whose main symptoms are dyspnea and cough. These symptoms also occur mainly in various airway diseases. However, to date, the prevalence of airway disease in patients with IPF has not been well studied. Therefore, this paper attempts to evaluate the prevalence of airway diseases including asthma, eosinophilic bronchitis (EB), chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO) in IPF.
Method
This study, as a single-institution prospective study, is proposed from June 2017 to September 2017 at the Seoul national university hospital. To evaluate the presence of airway disease, spirometry with bronchodilator, metacholine provocation test, induced sputum with eosinophil stain, multiple antigen simultaneous test (MAST), exhaled nitric oxide (FENO), serum IgE, and blood eosinophil count were performed. To elucidate the differences in quality of life (QOL) and symptoms-severity, according to the existence of combined airway disease, questionnaire for QOL (CAT, SGRQ, EQ-5D) and symptom severity (mMRC, 6-minute walk test, CQLQ) were performed.
Result
45 patients were enrolled in this study. The prevalence of airway disease was 40.0% (18/45). 15 patients were diagnosed with EB (33.3%), 2 with COPD (4.4%), 1 with asthma (2.2%), none with ACO. The number of patients with increased inflammatory biomarkers were 24 (53.3%) and among them, 18 were with moderate to high level of MAST (40.0%), 4 with a high level of FENO (>50 ppb, 8.9%), 12 with increased serum IgE (>100 IU/mL, 26.7%), 3 with blood eosinophilia (>500, 6.7%). QOL and symptom-severity were not different regardless of existence of airway disease.
Conclusion
Our study suggests that EB is prevalent in patients with IPF, while others such as asthma, COPD, and ACO are not. It is necessary to conduct a research on a larger number of patients in the future. A subsequent study is ongoing to evaluate the improvement of QOL and symptom severities after active treatment for the airway diseases.
Author Block: P. Hee Moon, J. Lee, Y. Park, C. Lee, S. Lee, J. Yim, C. Yoo, Y. Kim, S. K. Han, S. Choi; Internal Medicine, Seoul National University Hospital, Seoul, Korea, Republic of.
RATIONALE
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial pneumonia whose main symptoms are dyspnea and cough. These symptoms also occur mainly in various airway diseases. However, to date, the prevalence of airway disease in patients with IPF has not been well studied. Therefore, this paper attempts to evaluate the prevalence of airway diseases including asthma, eosinophilic bronchitis (EB), chronic obstructive pulmonary disease (COPD), and asthma-COPD overlap (ACO) in IPF.
Method
This study, as a single-institution prospective study, is proposed from June 2017 to September 2017 at the Seoul national university hospital. To evaluate the presence of airway disease, spirometry with bronchodilator, metacholine provocation test, induced sputum with eosinophil stain, multiple antigen simultaneous test (MAST), exhaled nitric oxide (FENO), serum IgE, and blood eosinophil count were performed. To elucidate the differences in quality of life (QOL) and symptoms-severity, according to the existence of combined airway disease, questionnaire for QOL (CAT, SGRQ, EQ-5D) and symptom severity (mMRC, 6-minute walk test, CQLQ) were performed.
Result
45 patients were enrolled in this study. The prevalence of airway disease was 40.0% (18/45). 15 patients were diagnosed with EB (33.3%), 2 with COPD (4.4%), 1 with asthma (2.2%), none with ACO. The number of patients with increased inflammatory biomarkers were 24 (53.3%) and among them, 18 were with moderate to high level of MAST (40.0%), 4 with a high level of FENO (>50 ppb, 8.9%), 12 with increased serum IgE (>100 IU/mL, 26.7%), 3 with blood eosinophilia (>500, 6.7%). QOL and symptom-severity were not different regardless of existence of airway disease.
Conclusion
Our study suggests that EB is prevalent in patients with IPF, while others such as asthma, COPD, and ACO are not. It is necessary to conduct a research on a larger number of patients in the future. A subsequent study is ongoing to evaluate the improvement of QOL and symptom severities after active treatment for the airway diseases.
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