TY - JOUR
T1 - Implications of the 2022 lung function update and GLI global reference equations among patients with interstitial lung disease
AU - Li, Andrew
AU - Teoh, Alan
AU - Troy, Lauren
AU - Glaspole, Ian
AU - Wilsher, Margaret L.
AU - de Boer, Sally
AU - Wrobel, Jeremy
AU - Moodley, Yuben P.
AU - Thien, Francis
AU - Gallagher, Henry
AU - Galbraith, Michelle
AU - Chambers, Daniel C.
AU - Mackintosh, John
AU - Goh, Nicole
AU - Khor, Yet Hong
AU - Edwards, Adrienne
AU - Royals, Karen
AU - Grainge, Christopher
AU - Kwan, Benjamin
AU - Keir, Gregory J.
AU - Ong, Chong
AU - Reynolds, Paul N.
AU - Veitch, Elizabeth
AU - Chai, Gin Tsen
AU - Ng, Ziqin
AU - Tan, Geak Poh
AU - Jackson, Dan
AU - Corte, Tamera
AU - Jo, Helen
PY - 2024/10
Y1 - 2024/10
N2 - Background: Lung function testing remains a cornerstone in the assessment and management of interstitial lung disease (ILD) patients. The clinical implications of the Global Lung function Initiative (GLI) reference equations and the updated interpretation strategies remain uncertain. Methods: Adult patients with ILD with baseline forced vital capacity (FVC) were included from the Australasian ILD registry and the National Healthcare Group ILD registry, Singapore. The European Coal and Steel Community and Miller reference equations were compared with the GLI reference equations to assess (a) differences in lung function percent predicted values; (b) ILD risk prediction models and (c) eligibility for ILD clinical trial enrolment. Results: Among 2219 patients with ILD, 1712 (77.2%) were white individuals. Idiopathic pulmonary fibrosis (IPF), connective tissue disease-associated ILD and unclassifiable ILD predominated. Median FVC was 2.60 (2.01-3.36)L, forced expiratory volume in 1 s was 2.09 (1.67-2.66)L and diffusing capacity of the lungs for carbon monoxide (DLCO) was 13.60 (10.16-17.60)mL/min/mm Hg. When applying the GLI reference equations, the mean FVC percentage predicted was 8.8% lower (87.7% vs 78.9%, p<0.01) while the mean DLCO percentage predicted was 4.9% higher (58.5% vs 63.4%, p<0.01). There was a decrease in 19 IPF and 119 non-IPF patients who qualified for the nintedanib clinical trials when the GLI reference equations were applied. Risk prediction models performed similarly in predicting mortality using both reference equations. Conclusion: Applying the GLI reference equations in patients with ILD leads to higher DLCO percentage predicted values and smaller lung volume percentage predicted values. While applying the GLI reference equations did not impact on prognostication, fewer patients met the clinical trial criteria for antifibrotic agents.
AB - Background: Lung function testing remains a cornerstone in the assessment and management of interstitial lung disease (ILD) patients. The clinical implications of the Global Lung function Initiative (GLI) reference equations and the updated interpretation strategies remain uncertain. Methods: Adult patients with ILD with baseline forced vital capacity (FVC) were included from the Australasian ILD registry and the National Healthcare Group ILD registry, Singapore. The European Coal and Steel Community and Miller reference equations were compared with the GLI reference equations to assess (a) differences in lung function percent predicted values; (b) ILD risk prediction models and (c) eligibility for ILD clinical trial enrolment. Results: Among 2219 patients with ILD, 1712 (77.2%) were white individuals. Idiopathic pulmonary fibrosis (IPF), connective tissue disease-associated ILD and unclassifiable ILD predominated. Median FVC was 2.60 (2.01-3.36)L, forced expiratory volume in 1 s was 2.09 (1.67-2.66)L and diffusing capacity of the lungs for carbon monoxide (DLCO) was 13.60 (10.16-17.60)mL/min/mm Hg. When applying the GLI reference equations, the mean FVC percentage predicted was 8.8% lower (87.7% vs 78.9%, p<0.01) while the mean DLCO percentage predicted was 4.9% higher (58.5% vs 63.4%, p<0.01). There was a decrease in 19 IPF and 119 non-IPF patients who qualified for the nintedanib clinical trials when the GLI reference equations were applied. Risk prediction models performed similarly in predicting mortality using both reference equations. Conclusion: Applying the GLI reference equations in patients with ILD leads to higher DLCO percentage predicted values and smaller lung volume percentage predicted values. While applying the GLI reference equations did not impact on prognostication, fewer patients met the clinical trial criteria for antifibrotic agents.
KW - Connective tissue disease associated lung disease
KW - Idiopathic pulmonary fibrosis
KW - Interstitial Fibrosis
KW - Pulmonary vasculitis
KW - Rare lung diseases
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=uwapure5-25&SrcAuth=WosAPI&KeyUT=WOS:001320500700001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1136/thorax-2024-221813
DO - 10.1136/thorax-2024-221813
M3 - Article
C2 - 39317451
SN - 0040-6376
VL - 79
SP - 1024
EP - 1032
JO - Thorax
JF - Thorax
IS - 10
ER -