A modified Delphi exercise in physician-perceived risk factors for drug-induced pneumotoxicity in patients with rheumatological disease
Makaleler > Tam Makale · 2024
Yazarlar: Manjit K. Cartlidge, Kevin K. Brown, Kevin K. Brown, Nazia Chaudhuri, Tamera J. Corte, Phillipe Dieudé, Phillipe Dieudé, Levin John, Clive Kelly, Dinesh Khanna, Dinesh Khanna, Euan McRorie, Lisa Nicol, Gareth Stewart, Simon L.F. Walsh, Marlies Wijsenbeek, Nik Hirani, Hilario Nunes, Deborah Assaya, Sameep Sehga, Simon M. Stebbings, Alejandro Robles-Perez, Anjali Crawshaw, Gunnar Gudmundsson, H. C. Blum, Bruno Crestani, Paola Confalonieri, Marco Sebastiani, Armando Gabrielli, Elisabetta Balestro, Esen Kiyan, Jadranka Morovic-Vergles, Virginia Berlengiero, Pilar Rivera-Ortega, Toshiaki Matsuda, Vera Bernardino, Peter Saunders, Kristina Frketic Marovic, Alberto Sulli, Ivo van der Lee, Andreina Manfredi, Abdulla Al-farttoosi, Corrado Campochiaro, E. J. Nossent, Michele Iudici, Christopher J. Ryerson, Silvia Grazzini, Emma Derrett-Smith, Helen Parfrey, Venero MdC, Yuko Waseda, Yuko Waseda, Davide Mohammed Reza Beiga, Elvis Hysa, Claudia Lucia Toma, Alain Delobbe, Lisa G. Spencer, Godoy, Su Ying Low, Nesrin MOĞULKOÇ BISHOP, Yasemin Kabasakal, Dijana Perkovic, Alessandra Della Ross, Ali Fuat Kalyoncu, Joshua J. Solomon, Liudmila Garzanova, Simona Rednic, Nasser Al Busaid, Shital Patil, Pierre Antoine Juge, Rosario Foti, Edoardo Rosato, Sergio Campainha, Richard Mathew Jones, Claudia Cobilinschi, Claudia Cobilinschi, Martin Kolb, Martin Kolb, Ana Maria Gheorghiu, Kristin B. Highland, Kristin B. Highland, Tracy Luckhardt, Keisuke Tomii, Shigeki Saiton, Alfredo Guillen, Angela Ceribelli, Aditya Agrawal, Raphael Borie, Gareth A. Stewart, Rebecca Grainger, Danielle Antin-Ozerkis, Maria Teresa Rio Ramirez, Jens Vikse, Fotio Drakopanagiotakis, Randolph J. Lipchik, Diego Castillo, Álvaro Garcia Martos, Lisa M. Nicol, Philip V. Gardiner, Semra Bilaceroglu
BMC PULMONARY MEDICINE, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Scopus, 2024, cilt 24, ss 547-547
DOI: 10.1186/s12890-024-03287-0
Özet
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.