Extract
According to a survey study of Wijsenbeek and colleagues [1], 76% of respiratory physicians believe fibrotic Hypersensitivity Pneumonitis (fibrotic HP, fHP) should be treated with corticosteroids (CS) as first line treatment. However, data to support such a strategy are limited and confined to acute farmer's lung [2]. Classically, HP patients are classified according to symptom chronicity in acute and chronic HP [3]. Based on new data, however, a stratification according to the (radiological) presence of fibrosis seems more in line with prognosis [4]. In an earlier study [5], we demonstrated that CS treatment was only beneficial in non-fibrotic HP (nfHP) while CS was not effective in fHP, both in terms of survival, FVC% decline and DLCO% decline. In this study, we determined whether the presence of broncho-alveolar lavage lymphocytosis (BAL Lymphocytosis, BALL) or honeycombing (HC) influences the treatment effect of CS in fHP patients.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. De Sadeleer reports non-financial support from Roche, non-financial support from Boehringer Ingelheim, outside the submitted work.
Conflict of interest: Dr. Hermans has nothing to disclose.
Conflict of interest: Dr. De Dycker has nothing to disclose.
Conflict of interest: Dr. Yserbyt has nothing to disclose.
Conflict of interest: Dr. Verschakelen has nothing to disclose.
Conflict of interest: Dr. Verbeken has nothing to disclose.
Conflict of interest: Dr. Verleden has nothing to disclose.
Conflict of interest: Dr. E. Verleden has nothing to disclose.
Conflict of interest: Dr. Wuyts reports grants from Roche, grants from Boehringer-Ingelheim, outside the submitted work.
- Received October 11, 2019.
- Accepted December 26, 2019.
- Copyright ©ERS 2020
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