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1. Maintenance OCS Were Used More Frequently Than Biologics in Patients with Uncontrolled GINA 4/5 Asthma in Germany in 2019

Author

Milger K, Koschel D, Skowasch D, Timmermann H, Schmidt O, Bergmann KC, Neurohr C, Lindner R, Heck S, and Virchow JC

Subjects
prescription database, disease analyzer, uncontrolled asthma, biological treatment, ocs use, germany, guideline adherence., Immunologic diseases. Allergy, RC581-607
Abstract

Katrin Milger,1 Dirk Koschel,2 Dirk Skowasch,3 Hartmut Timmermann,4 Olaf Schmidt,5 Karl-Christian Bergmann,6 Claus Neurohr,7 Robert Lindner,8 Sebastian Heck,9 Johann Christian Virchow10 1Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria; 2Division of Pneumonology, Medical Department I, University Hospital Carl Gustav Carus, Dresden and Fachkrankenhaus Coswig, Lung Centre, Coswig, Germany; 3Department of Internal Medicine II – Pneumology, University Hospital Bonn, Bonn, Germany; 4Schwerpunktpraxis Colonnaden, Hamburg, Germany; 5Pneumologische Gemeinschaftspraxis und Studienzentrum KPPK, Koblenz, Germany; 6Institute for Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; 7Abteilung für Pneumologie und Beatmungsmedizin, Robert-Bosch-Krankenhaus Lungenzentrum, Stuttgart, Germany; 8IQVIA Commercial GmbH & Co. OHG, Frankfurt Am Main, Germany; 9GlaxoSmithKline GmbH & Co. KG, Munich, Germany; 10Abteilung Pneumologie & Interdisziplinäre Internistische Intensivmedizin, Universitätsmedizin Rostock - Zentrum für Innere Medizin, Medizinische Klinik I, Rostock, GermanyCorrespondence: Katrin Milger, Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz, 8036, Austria, Email katrin.milger-kneidinger@medunigraz.atPurpose: Asthma is affecting 4– 5% of all adults (10% of children) in Germany, ≥ half are inadequately controlled. In 2019 up to 54 thousand patients suffered from severe uncontrolled asthma, 52% were treated/co-treated by pneumonologists. 45% of them had continuous oral corticosteroid (OCS)- and short-acting β 2-agonist (SABA) overuse for ≥ 2 years. The aim of the current study was to analyze the main treatments, escalation schemes and the adherence to the GINA recommendations.Patients and Methods: Retrospective analysis in 2021 based on data from January to December 2019 in Germany, using the IQVIA™ LRx prescription database and the IQVIA™ Disease Analyzer database containing anonymized electronic medical records as the main data sources.Results: In 2019 25,200 patients with severe, uncontrolled asthma treated in a pneumonologist´s practice in Germany received GINA 3 (0,4%), GINA 4 (76%) or GINA 5 therapy (24%) during the study year compared to 59% GINA 5 therapy in the 5– 10% (1,500– 3,000) co-treated in a specialized outpatient department. In Pneumonologists` practices the most frequent choice in GINA 5 was OCS in 69% of patients (biologicals 37%, long-acting muscarinic antagonist (LAMA) 20%) compared to 66% biologicals, 55% OCS, and 25% LAMA in the outpatient department. 54,958 of 613,000 GINA 4/5 patients were treated with OCS, 9,725 even with doses above the so called “Cushing threshold” for prednisolone of 2700 mg/year. After introduction of a biological treatment, patients reduced their SABA prescriptions by 28%, OCS by 55%, and OCS overall exposure by 40%, one-third did not need OCS anymore.Conclusion: In 75% of patients with uncontrolled asthma for ≥ 2 years therapy was not escalated beyond GINA 4 or low dose OCS was used as the most frequent add-on treatment in GINA 5 contradictory to treatment recommendations. Use of biologics reduced on demand rescue medication and OCS use.Keywords: prescription database, disease analyzer, uncontrolled asthma, biological treatment, OCS use, Germany, guideline adherence

Published
2024

2. Health Care Situation in the Treatment of Uncontrolled GINA Step 4/5 Patients in Germany

Author

Timmermann H, Milger K, Virchow JC, Schmidt O, Bergmann KC, Koschel D, Neurohr C, Scholz F, Heck S, and Skowasch D

Subjects
prescription database, biological treatment, laboratory test, uncontrolled gina step4/5 asthma, germany., Immunologic diseases. Allergy, RC581-607
Abstract

Hartmut Timmermann,1 Katrin Milger,2 Johann Christian Virchow,3 Olaf Schmidt,4 Karl-Christian Bergmann,5 Dirk Koschel,6 Claus Neurohr,7 Florian Scholz,8 Sebastian Heck,9 Dirk Skowasch10 1Schwerpunktpraxis Colonnaden, Hamburg, Germany; 2Medicine V, Ludwig-Maximilians-University (LMU) Munich, Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany; 3Abteilungen für Pneumologie / Intensivmedizin, Universitätmedizin Rostock, Rostock, Germany; 4Studienzentrum KPPK, Pneumologische Gemeinschaftspraxis, Koblenz, Germany; 5Institute of Allergology, Charité–Universitätsmedizin, Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Corporate Member of Freie Universität Berlin and Humboldt-Universität Berlin, Berlin, Germany; 6Fachkrankenhaus Coswig, Lung Centre, Coswig, and Division of Pulmonology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany; 7Abteilung für Pneumologie und Beatmungsmedizin, Robert-Bosch-Krankenhaus Lungenzentrum Stuttgart, Stuttgart, Germany; 8IQVIA Commercial GmbH & Co. OHG, Frankfurt am Main, Germany; 9GlaxoSmithKline GmbH & Co. KG, Munich, Germany; 10Department of Internal Medicine II – Pneumology, University Hospital Bonn, Bonn, GermanyCorrespondence: Hartmut Timmermann, Schwerpunktpraxis Colonnaden 72, Hamburg, 20354, Germany, Tel +49 4086648880, Fax +49 40866488824, Email timmermann@allergopraxis.dePurpose: It has been estimated that, in 2019, 54,000 patients in Germany had uncontrolled GINA step 4/5 asthma. In the current study we analyzed which health care providers were involved in the management of these patients and their role in disease phenotyping.Patients and Methods: The year 2019 was retrospectively analyzed using the IQVIATM LRx, a longitudinal anonymized prescription database, and the electronic, anonymized medical records database, the IQVIA Disease Analyzer.Results: Of 54,000 uncontrolled GINA step 4/5 asthma patients in Germany, 52% had consulted both general practitioners (GPs) and pulmonologists, and 48% were seen exclusively by a GP. Of these 54,000 patients, 45% were being prescribed and were thus overusing short-acting β 2-agonists (SABAs) and oral corticosteroids (OCS) for ≥ 2 years, 26% for ≥ 3 years, and 16% for ≥ 4 years. In most regions, pulmonologists saw one of their uncontrolled GINA step 4/5 asthma patients per week. Laboratory tests from consultations with a GP were available for only 10% of patients referred to a pulmonologist. In 50% of uncontrolled asthma patients treated according to GINA step 4/5, these were initiated by the pulmonologist, and 34% received laboratory testing within the first year (in GINA step 4/5 asthma, the numbers are 20% and 18%, respectively).Conclusion: Fifty percent of uncontrolled asthma patients treated according to GINA step 4/5 were regularly seen by pulmonologists, who performed most of the phenotyping confirming their importance in the management of severe, uncontrolled asthma in Germany. To understand treatment pathways for these patients, further studies are needed.Keywords: prescription database, biological treatment, laboratory test, uncontrolled GINA step 4/5 asthma, Germany

Published
2023

3. Prevalence of Patients with Uncontrolled Asthma Despite NVL/GINA Step 4/5 Treatment in Germany

Author

Bergmann KC, Skowasch D, Timmermann H, Lindner R, Virchow JC, Schmidt O, Koschel D, Neurohr C, Heck S, and Milger K

Subjects
prescription database, disease analyzer, uncontrolled asthma, oral corticosteroid (ocs), short-acting β2-agonist (saba)., Immunologic diseases. Allergy, RC581-607
Abstract

Karl-Christian Bergmann,1 Dirk Skowasch,2 Hartmut Timmermann,3 Robert Lindner,4 Johann Christian Virchow,5 Olaf Schmidt,6 Dirk Koschel,7 Claus Neurohr,8 Sebastian Heck,9 Katrin Milger10 1Institute for Allergology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany; 2Department of Internal Medicine II – Pneumology, University Hospital Bonn, Bonn, Germany; 3Schwerpunktpraxis Colonnaden, Hamburg, Germany; 4IQVIA Commercial GmbH & Co. OHG, Frankfurt Am Main, Germany; 5Universitätsmedizin Rostock - Zentrum für Innere Medizin, Medizinische Klinik I, Abteilung Pneumologie & Interdisziplinäre Internistische Intensivmedizin, Rostock, Germany; 6Pneumologische Gemeinschaftspraxis und Studienzentrum KPPK, Koblenz, Germany; 7Fachkrankenhaus Coswig, Lung Centre, Coswig, and Division of Pulmonology, Medical Department I, University Hospital Carl Gustav Carus, Dresden, Germany; 8Abteilung für Pneumologie und Beatmungsmedizin, Robert-Bosch-Krankenhaus Lungenzentrum, Stuttgart, Germany; 9GlaxoSmithKline GmbH & Co. KG, Munich, Germany; 10Department of Medicine V, University Hospital, Ludwig-Maximilians-University (LMU) Munich, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, GermanyCorrespondence: Karl-Christian Bergmann, Institute for Allergology-Charité, Luisenstraße 2, Berlin, 10117, Germany, Tel +491711934508, Fax +49 30 549090609, Email karlchristianbergmann@gmail.comPurpose: Asthma is one of the most prevalent chronic diseases in Germany affecting 4– 5% of all adults and 10% of children. Despite the availability of biologicals in recent years, studies show patients with inadequately controlled severe asthma in real life. The aim of the current study was to characterize and estimate the number of patients with NVL/GINA level 4 or 5 asthma and signs of poor control in Germany.Patients and Methods: In 2021, we retrospectively analyzed data collected during 2019 using the IQVIA™ LRx and IQVIA™ Disease Analyzer databases which contain anonymized longitudinal data covering approximately 80% of statutory health insurance (GKV) prescriptions in Germany with most relevant information about prescriptions, basic patient demographics or location of the prescriber; the IQVIA™ Disease Analyzer anonymized electronic medical records from a representative sample of office-based GPs and specialists. An expert committee of pulmonologists from different hospitals and expert practices supported the study. Asthma patients treated according to NVL/GINA 4/5 who used SABAs frequently (≥ 3 on days with no ICS-containing prescriptions/year) and/or received prescriptions for oral corticosteroids (OCS) (score of ≥ 2/year, a pulmonologist prescription scored 1.0, GP 0.75) were classified as severe, uncontrolled asthma.Results: In 2019, 3.4 million patients received at least two prescriptions of respiratory medications and 2.4 million patients on maintenance respiratory treatment have asthma. A total of 625,000 asthma patients were treated according to NVL/GINA step 4 or 5. Among these, 54,000 were uncontrolled according to the pre-defined OCS and/or SABA use, which corresponds to approximately 15% of patients in certain regions.Conclusion: In 2019, approximately 54,000 patients in Germany treated according to NVL/GINA step 4/5 had evidence suggestive for poor asthma control, up to 15% of patients in certain regions. Yet, only 12,000 patients overall were being treated with biologicals suggesting a possible treatment gap that requires further investigation.Keywords: prescription database, disease analyzer, uncontrolled asthma, oral corticosteroid, OCS, short-acting β 2-agonist, SABA

Published
2022

4. Nintedanib in patients with progressive fibrosing interstitial lung diseases—subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial

Author

Abe, S., Aburto, M., Acosta, O., Andrews, C., Antin-Ozerkis, D., Arce, G., Arias, M., Avdeev, S., Barczyk, A., Bascom, R., Bazdyrev, E., Beirne, P., Belloli, E., Bergna, M.A., Bergot, E., Bhatt, N., Blaas, S., Bondue, B., Bonella, F., Britt, E., Buch, K., Burk, J., Cai, H., Cantin, A., Castillo Villegas, D.M., Cazaux, A., Cerri, S., Chaaban, S., Chaudhuri, N., Cottin, V., Crestani, B., Criner, G., Dahlqvist, C., Danoff, S., Dematte D'Amico, J., Dilling, D., Elias, P., Ettinger, N., Falk, J., Fernández Pérez, E.R., Gamez-Dubuis, A., Giessel, G., Gifford, A., Glassberg, M., Glazer, C., Golden, J., Gómez Carrera, L., Guiot, J., Hallowell, R., Hayashi, H., Hetzel, J., Hirani, N., Homik, L., Hope-Gill, B., Hotchkin, D., Ichikado, K., Ilkovich, M., Inoue, Y., Izumi, S., Jassem, E., Jones, L., Jouneau, S., Kaner, R., Kang, J., Kawamura, T., Kessler, R., Kim, Y., Kishi, K., Kitamura, H., Kolb, M., Kondoh, Y., Kono, C., Koschel, D., Kreuter, M., Kulkarni, T., Kus, J., Lebargy, F., León Jiménez, A., Luo, Q., Mageto, Y., Maher, T.M., Makino, S., Marchand-Adam, S., Marquette, C., Martinez, R., Martínez, M., Maturana Rozas, R., Miyazaki, Y., Moiseev, S., Molina-Molina, M., Morrison, L., Morrow, L., Moua, T., Nambiar, A., Nishioka, Y., Nunes, H., Okamoto, M., Oldham, J., Otaola, M., Padilla, M., Park, J.S., Patel, N., Pesci, A., Piotrowski, W., Pitts, L., Poonyagariyagorn, H., Prasse, A., Quadrelli, S., Randerath, W., Refini, R., Reynaud-Gaubert, M., Riviere, F., Rodríguez Portal, J.A., Rosas, I., Rossman, M., Safdar, Z., Saito, T., Sakamoto, N., Salinas Fénero, M., Sauleda, J., Schmidt, S., Scholand, M.B., Schwartz, M., Shapera, S., Shlobin, O., Sigal, B., Silva Orellana, A., Skowasch, D., Song, J.W., Stieglitz, S., Stone, H., Strek, M., Suda, T., Sugiura, H., Takahashi, H., Takaya, H., Takeuchi, T., Thavarajah, K., Tolle, L., Tomassetti, S., Tomii, K., Valenzuela, C., Vancheri, C., Varone, F., Veeraraghavan, S., Villar, A., Weigt, S., Wemeau, L., Wuyts, W., Xu, Z., Yakusevich, V., Yamada, Y., Yamauchi, H., Ziora, D., Wells, Athol U, Flaherty, Kevin R, Brown, Kevin K, Inoue, Yoshikazu, Devaraj, Anand, Richeldi, Luca, Moua, Teng, Crestani, Bruno, Wuyts, Wim A, Stowasser, Susanne, Quaresma, Manuel, Goeldner, Rainer-Georg, Schlenker-Herceg, Rozsa, and Kolb, Martin

Published
2020
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6. Impact of TP53 mutation status on systemic treatment outcome in ALK-rearranged non-small-cell lung cancer

Author

Kron, A., Alidousty, C., Scheffler, M., Merkelbach-Bruse, S., Seidel, D., Riedel, R., Ihle, M.A., Michels, S., Nogova, L., Fassunke, J., Heydt, C., Kron, F., Ueckeroth, F., Serke, M., Krüger, S., Grohe, C., Koschel, D., Benedikter, J., Kaminsky, B., Schaaf, B., Braess, J., Sebastian, M., Kambartel, K -O, Thomas, R., Zander, T., Schultheis, A.M., Büttner, R., and Wolf, J.

Published
2018
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8. Ziritaxestat, a novel autotaxin inhibitor, and lung function in idiopathic pulmonary fibrosis

Author

Maher, TM, Ford, P, Brown, KK, Costabel, U, Cottin, V, Danoff, SK, Groenveld, I, Helmer, E, Jenkins, RG, Milner, J, Molenberghs, G, Penninckx, B, Randall, MJ, Van Den Blink, B, Fieuw, A, Vandenrijn, C, Rocak, S, Seghers, I, Shao, L, Taneja, A, Jentsch, G, Watkins, TR, Wuyts, WA, Kreuter, M, Verbruggen, N, Prasad, N, Wijsenbeek, MS, Chambers, D, Chia, M, Corte, T, Glaspole, I, Goh, N, Holmes, M, Malouf, M, Thien, F, Veitch, E, Bondue, B, Dahlqvist, C, Froidure, A, Slabbynck, H, Wuyts, W, Cartagena Salinas, C, Feijoó Seoane, R, Martínez, V, Maturana, R, Pavie Gallegos, J, Rosenblut, A, Silva, R, Undurraga Pereira, A, Doubkova, M, Pauk, N, Plackova, M, Sterclova, M, Bendstrup, E, Shaker, SB, Titlestad, I, Budweiser, S, Grohé, C, Koschel, D, Prasse, A, Weber, M, Wirtz, H, Antoniou, K, Daniil, Z, Gaga, M, Papakosta, D, Izumi, S, Okamoto, M, Guerreros Benavides, A, Iberico Barrera, C, Peña Villalobos, AM, Campo Ezquibela, A, Cifrian Martinez, JM, Fernandez Fabrellas, E, Leiro, V, Molina-Molina, M, Nieto Barbero, A, Sellares Torres, J, Valenzuela, C, Cheng, S-L, Kuo, P-H, Lee, K-Y, Sheu, C-C, Gunen, H, Mogulkoc Bishop, N, Nayci, S, Adamali, H, Bianchi, S, Chaudhuri, N, Gibbons, M, Hart, S, Molyneaux, P, Parfrey, H, Saini, G, Spencer, LG, Wiscombe, S, Antin-Ozerkis, D, Bascom, R, Belperio, J, Britt, E, Fitzgerald, J, Gomez Manjarres, D, Gotfried, M, Gupta, N, Hotchkin, D, Kaye, M, Kreider, M, Kureishy, S, Lacamera, P, Lancaster, L, Lasky, J, Lorch, D, Mannem, H, Morrow, L, Moua, T, Nambiar, A, Raghu, G, Raj, R, Ramaswamy, M, Reddy, R, Russell, T, Scholand, MB, Shea, B, Suliman, S, Swigris, J, Thavarajah, K, Tolle, L, Tomic, R, Warshoff, N, Wesselius, L, Yung, G, Bergna, M, De Salvo, M, Fernandez Acquier, M, Rodriguez, A, Saez Scherbovsky, P, Assayag, D, Dhar, A, Khalil, N, Morisset, J, Provencher, S, Ryerson, C, Shapera, S, Bourdin, A, Crestani, B, Lebargy, F, Reynaud-Gaubert, M, Bonella, FT, Claussen, M, Hammerl, P, Karagiannidis, C, Keller, C, Randerath, W, Stubbe, B, Csánky, E, Medgyasszay, B, Muller, V, Adir, Y, Bar-Shai, A, Berkman, N, Fink, G, Kramer, M, Shitrit, D, Bargagli, E, Gasparini, S, Harari, S, Ravaglia, C, Richeldi, L, Vancheri, C, Ebina, M, Fujita, M, Ichikado, K, Inoue, Y, Ishikawa, N, Kato, M, Kawamura, T, Kondoh, Y, Nishioka, Y, Ogura, T, Owan, I, Saito, T, Sakamoto, N, Sakamoto, K, Shirai, M, Suda, T, Tomii, K, Chung, MP, Jeong, SH, Park, CS, Park, JS, Song, JW, Uh, S-T, Chavarria Martinez, U, Montano Gonzalez, E, Ramirez, A, Selman Lama, ME, Bresser, P, Kramer, H, Mostard, R, Nossent, E, Veltkamp, M, Wijsenbeek, M, Beckert, L, Chang, CL, Veale, A, Wilsher, M, Bednarek, M, Gasior, G, Jasieniak-Pinis, G, Jassem, E, Mroz, R, Piotrowski, W, Abdullah, I, Ambaram, A, Irusen, E, Van der Linden, M, Van Zyl-Smit, R, Williams, P, Allen, J, Averill, F, Belloli, E, Brown, A, Case, A, Chaudhary, S, Criner, G, DeBoer, K, Dilling, D, Dorf, J, Enelow, R, Ettinger, N, Feldman, J, Gibson, K, Golden, J, Hamblin, M, Hunninghake, G, Karunakara, R, Kim, H, Luckhardt, T, Menon, P, Morrison, L, Oldham, J, Patel, N, Schmidt, S, Strek, M, Summer, R, Sussman, R, Tita, J, Veeraraghavan, S, Whelan, T, and Zibrak, J

Abstract

Importance There is a major need for effective, well-tolerated treatments for idiopathic pulmonary fibrosis (IPF). Objective To assess the efficacy and safety of the autotaxin inhibitor ziritaxestat in patients with IPF. Design, Setting, and Participants The 2 identically designed, phase 3, randomized clinical trials, ISABELA 1 and ISABELA 2, were conducted in Africa, Asia-Pacific region, Europe, Latin America, the Middle East, and North America (26 countries). A total of 1306 patients with IPF were randomized (525 patients at 106 sites in ISABELA 1 and 781 patients at 121 sites in ISABELA 2). Enrollment began in November 2018 in both trials and follow-up was completed early due to study termination on April 12, 2021, for ISABELA 1 and on March 30, 2021, for ISABELA 2. Interventions Patients were randomized 1:1:1 to receive 600 mg of oral ziritaxestat, 200 mg of ziritaxestat, or placebo once daily in addition to local standard of care (pirfenidone, nintedanib, or neither) for at least 52 weeks. Main Outcomes and Measures The primary outcome was the annual rate of decline for forced vital capacity (FVC) at week 52. The key secondary outcomes were disease progression, time to first respiratory-related hospitalization, and change from baseline in St George’s Respiratory Questionnaire total score (range, 0 to 100; higher scores indicate poorer health-related quality of life). Results At the time of study termination, 525 patients were randomized in ISABELA 1 and 781 patients in ISABELA 2 (mean age: 70.0 [SD, 7.2] years in ISABELA 1 and 69.8 [SD, 7.1] years in ISABELA 2; male: 82.4% and 81.2%, respectively). The trials were terminated early after an independent data and safety monitoring committee concluded that the benefit to risk profile of ziritaxestat no longer supported their continuation. Ziritaxestat did not improve the annual rate of FVC decline vs placebo in either study. In ISABELA 1, the least-squares mean annual rate of FVC decline was –124.6 mL (95% CI, −178.0 to −71.2 mL) with 600 mg of ziritaxestat vs –147.3 mL (95% CI, −199.8 to −94.7 mL) with placebo (between-group difference, 22.7 mL [95% CI, −52.3 to 97.6 mL]), and –173.9 mL (95% CI, −225.7 to −122.2 mL) with 200 mg of ziritaxestat (between-group difference vs placebo, −26.7 mL [95% CI, −100.5 to 47.1 mL]). In ISABELA 2, the least-squares mean annual rate of FVC decline was –173.8 mL (95% CI, −209.2 to −138.4 mL) with 600 mg of ziritaxestat vs –176.6 mL (95% CI, −211.4 to −141.8 mL) with placebo (between-group difference, 2.8 mL [95% CI, −46.9 to 52.4 mL]) and –174.9 mL (95% CI, −209.5 to −140.2 mL) with 200 mg of ziritaxestat (between-group difference vs placebo, 1.7 mL [95% CI, −47.4 to 50.8 mL]). There was no benefit with ziritaxestat vs placebo for the key secondary outcomes. In ISABELA 1, all-cause mortality was 8.0% with 600 mg of ziritaxestat, 4.6% with 200 mg of ziritaxestat, and 6.3% with placebo; in ISABELA 2, it was 9.3% with 600 mg of ziritaxestat, 8.5% with 200 mg of ziritaxestat, and 4.7% with placebo. Conclusions and Relevance Ziritaxestat did not improve clinical outcomes compared with placebo in patients with IPF receiving standard of care treatment with pirfenidone or nintedanib or in those not receiving standard of care treatment. Trial Registration ClinicalTrials.gov Identifiers: NCT03711162 and NCT03733444

Published
2023

16. Diagnose der idiopathischen Lungenfibrose – die neuen Leitlinien

Author

Koschel, D.

Abstract

Die idiopathische Lungenfibrose (IPF) ist eine der häufigsten interstitiellen Lungenerkrankungen (ILD). Dabei stellt die korrekte Diagnose einer IPF immer wieder eine Herausforderung dar. Kürzlich erschienen 2 internationale Empfehlungen zur Diagnostik der IPF, die den aktuellen Wissensstand zusammenfassen. Vor allem der notwendige Ausschluss anderer Ursachen einer ILD ist von dem Umfang der durchgeführten Diagnostik und oftmals auch von der Erfahrung des behandelnden Arztes abhängig. Im Mittelpunkt stehen weiterhin die HRCT(hochauflösende Computertomographie)-Untersuchung des Thorax und die entsprechende Beschreibung verschiedener Bildmuster. In Abhängigkeit davon ergibt sich die Notwendigkeit einer Lungenbiopsie mit analoger Beschreibung bestimmter Gewebemuster. Mittels eines multidisziplinären Teams erfolgt dann die definitive Diagnosestellung.

Published
2024
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24. S2K-Leitlinie zur Diagnostik der idiopathischen Lungenfibrose

Author

Behr, J., Günther, A., Bonella, Francesco, Dinkel, J., Fink, L., Geiser, T., Geiβler, K., Gläser, S., Handzhhiev, S., Jonigk, D., Koschel, D., Kreuter, M., Leuschner, G., Markart, P., Prasse, A., Schönfeld, N., Schupp, J.C., Sitter, H., Müller-Quernheim, J., Costabel, U., Geißler, K., and Publica

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, High-resolution computed tomography, Medizin, Lung biopsy, 03 medical and health sciences, Idiopathic pulmonary fibrosis, 0302 clinical medicine, medicine, 030212 general & internal medicine, 610 Medicine & health, Intensive care medicine, Lung, medicine.diagnostic_test, business.industry, Interstitial lung disease, Guideline, respiratory system, medicine.disease, humanities, Diagnosis of exclusion, respiratory tract diseases, medicine.anatomical_structure, Bronchoalveolar lavage, 030228 respiratory system, business
Abstract

Idiopathic pulmonary fibrosis (IPF) is a severe and often fatal disease. Diagnosis of IPF requires considerable expertise and experience. Since publication of the international IPF guideline in the year 2011 and Update 2018 several studies and technical advances occurred, which made a new assessment of the diagnostic process mandatory. In view of the antifibrotic drugs which have been approved for the treatment of IPF patients, the goal of this guideline is to foster early, confident and effective diagnosis of IPF. The guideline focusses on the typical clinical setting of an IPF patient and provides tools to exclude known causes of interstitial lung disease including standardised questionnaires, serologic testing and cellular analysis of bronchoalveolar lavage. High resolution computed tomography remains crucial in the diagnostic work-up. If it is necessary to obtain specimen for histology transbronchial lung cryobiopsy is the primary approach, while surgical lung biopsy is reserved for patients who are fit for it and in whom bronchoscopic diagnosis did not provide the information needed. Despite considerable progress, IPF remains a diagnosis of exclusion and multidisciplinary discussion remains the golden standard of diagnosis., Die idiopathische Lungenfibrose (IPF) ist eine schwerwiegende, chronische Lungenerkrankung, deren Diagnosestellung eine profunde fachliche Expertise verlangt. Seit Veröffentlichung der internationalen IPF-Leitlinie im Jahr 2011 mit Update 2018 haben zahlreiche Studien und technische Fortschritte eine Neubewertung des diagnostischen Vorgehens notwendig gemacht. Angesichts der Indikation, symptomatischen Patienten eine antifibrotische Therapie sofort nach Diagnosestellung zu empfehlen, hat die aktuelle IPF-Diagnostik-Leitlinie zum Ziel, die Diagnose der IPF möglichst ohne Verzögerung, wenig invasiv und zuverlässig zu ermöglichen. Sie beschreibt den typischen klinischen Kontext der IPF sowie die Untersuchungen, die zum Ausschluss bekannter Ursachen einer Lungenfibrose erforderlich sind, einschließlich standardisierter Anamneseerhebung, serologischer Testungen und zellulärer Analyse der bronchoalveolären Lavage. Zentrale Bedeutung kommt dem hochauflösenden Computertomogramm in Dünnschichttechnik zu. Sofern eine Histologie zur Diagnoseeingrenzung erforderlich ist, soll diese in erster Linie mittels der transbronchialen Lungen-Kryobiopsie gewonnen werden. Die chirurgische Lungenbiopsie soll Patienten vorbehalten bleiben, die in ausreichender Verfassung für diesen Eingriff sind und bei denen die endoskopische Diagnostik keine Klärung der Diagnose ergab. Goldstandard ist auch weiterhin die interdisziplinäre Diskussion der erhobenen Befunde, um nach Ausschluss anderer Formen chronisch progredienter Lungenfibrosen die Diagnose der IPF zu stellen.

Published
2020
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32. Sprachliche Validierung des Fibrose-Fragebogens zur Erfassung der Lebensqualität bei Patienten mit idiopathischer Lungenfibrose und idiopathischer nichtspezifischer interstitieller Pneumonie

Author

Kirsten, D., additional, de Vries, U., additional, Costabel, U., additional, Koschel, D., additional, Bonella, F., additional, Günther, A., additional, Behr, J., additional, Claussen, M., additional, Schwarz, S., additional, Prasse, A., additional, and Kreuter, M., additional

Published
2021
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34. Effects of nintedanib on progression of ILD in patients with fibrosing ILDs and a progressive phenotype: further analyses of the INBUILD trial

Author

Koschel, D, additional, Flaherty, K R, additional, Wells, A U, additional, Cottin, V, additional, Devaraj, A, additional, Inoue, Y, additional, Richeldi, L, additional, Walsh, S LF, additional, Kolb, M, additional, Moua, T, additional, Stowasser, S, additional, Goeldner, R G, additional, Schlenker-Herceg, R, additional, and Brown, K K, additional

Published
2021
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40. Nintedanib in patients with progressive fibrosing interstitial lung diseases—subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial

Author

Wells, Athol U, primary, Flaherty, Kevin R, additional, Brown, Kevin K, additional, Inoue, Yoshikazu, additional, Devaraj, Anand, additional, Richeldi, Luca, additional, Moua, Teng, additional, Crestani, Bruno, additional, Wuyts, Wim A, additional, Stowasser, Susanne, additional, Quaresma, Manuel, additional, Goeldner, Rainer-Georg, additional, Schlenker-Herceg, Rozsa, additional, Kolb, Martin, additional, Abe, S., additional, Aburto, M., additional, Acosta, O., additional, Andrews, C., additional, Antin-Ozerkis, D., additional, Arce, G., additional, Arias, M., additional, Avdeev, S., additional, Barczyk, A., additional, Bascom, R., additional, Bazdyrev, E., additional, Beirne, P., additional, Belloli, E., additional, Bergna, M.A., additional, Bergot, E., additional, Bhatt, N., additional, Blaas, S., additional, Bondue, B., additional, Bonella, F., additional, Britt, E., additional, Buch, K., additional, Burk, J., additional, Cai, H., additional, Cantin, A., additional, Castillo Villegas, D.M., additional, Cazaux, A., additional, Cerri, S., additional, Chaaban, S., additional, Chaudhuri, N., additional, Cottin, V., additional, Crestani, B., additional, Criner, G., additional, Dahlqvist, C., additional, Danoff, S., additional, Dematte D'Amico, J., additional, Dilling, D., additional, Elias, P., additional, Ettinger, N., additional, Falk, J., additional, Fernández Pérez, E.R., additional, Gamez-Dubuis, A., additional, Giessel, G., additional, Gifford, A., additional, Glassberg, M., additional, Glazer, C., additional, Golden, J., additional, Gómez Carrera, L., additional, Guiot, J., additional, Hallowell, R., additional, Hayashi, H., additional, Hetzel, J., additional, Hirani, N., additional, Homik, L., additional, Hope-Gill, B., additional, Hotchkin, D., additional, Ichikado, K., additional, Ilkovich, M., additional, Inoue, Y., additional, Izumi, S., additional, Jassem, E., additional, Jones, L., additional, Jouneau, S., additional, Kaner, R., additional, Kang, J., additional, Kawamura, T., additional, Kessler, R., additional, Kim, Y., additional, Kishi, K., additional, Kitamura, H., additional, Kolb, M., additional, Kondoh, Y., additional, Kono, C., additional, Koschel, D., additional, Kreuter, M., additional, Kulkarni, T., additional, Kus, J., additional, Lebargy, F., additional, León Jiménez, A., additional, Luo, Q., additional, Mageto, Y., additional, Maher, T.M., additional, Makino, S., additional, Marchand-Adam, S., additional, Marquette, C., additional, Martinez, R., additional, Martínez, M., additional, Maturana Rozas, R., additional, Miyazaki, Y., additional, Moiseev, S., additional, Molina-Molina, M., additional, Morrison, L., additional, Morrow, L., additional, Moua, T., additional, Nambiar, A., additional, Nishioka, Y., additional, Nunes, H., additional, Okamoto, M., additional, Oldham, J., additional, Otaola, M., additional, Padilla, M., additional, Park, J.S., additional, Patel, N., additional, Pesci, A., additional, Piotrowski, W., additional, Pitts, L., additional, Poonyagariyagorn, H., additional, Prasse, A., additional, Quadrelli, S., additional, Randerath, W., additional, Refini, R., additional, Reynaud-Gaubert, M., additional, Riviere, F., additional, Rodríguez Portal, J.A., additional, Rosas, I., additional, Rossman, M., additional, Safdar, Z., additional, Saito, T., additional, Sakamoto, N., additional, Salinas Fénero, M., additional, Sauleda, J., additional, Schmidt, S., additional, Scholand, M.B., additional, Schwartz, M., additional, Shapera, S., additional, Shlobin, O., additional, Sigal, B., additional, Silva Orellana, A., additional, Skowasch, D., additional, Song, J.W., additional, Stieglitz, S., additional, Stone, H., additional, Strek, M., additional, Suda, T., additional, Sugiura, H., additional, Takahashi, H., additional, Takaya, H., additional, Takeuchi, T., additional, Thavarajah, K., additional, Tolle, L., additional, Tomassetti, S., additional, Tomii, K., additional, Valenzuela, C., additional, Vancheri, C., additional, Varone, F., additional, Veeraraghavan, S., additional, Villar, A., additional, Weigt, S., additional, Wemeau, L., additional, Wuyts, W., additional, Xu, Z., additional, Yakusevich, V., additional, Yamada, Y., additional, Yamauchi, H., additional, and Ziora, D., additional

Published
2020
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42. Nintedanib in patients with chronic fibrosing Interstitial lung diseases with progressive phenotype: the INBUILD trial*

Author

Koschel, D, additional, Flaherty, KR, additional, Wells, AU, additional, Cottin, V, additional, Devaraj, A, additional, Inoue, Y, additional, Richeldi, L, additional, Walsh, S, additional, Stowasser, S, additional, Coeck, C, additional, Goeldner, RG, additional, Clerisme-Beaty, E, additional, Schlenker-Herceg, R, additional, and Brown, KK, additional

Published
2020
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48. Erratum to [German Guideline for Idiopathic Pulmonary Fibrosis]

Author

Behr, J, Günther, A, Bonella, F, Dinkel, J, Fink, L, Geiser, T., Geißler, K, Gläser, S, Handzhhiev, S, Jonigk, D, Koschel, D, Kreuter, M, Leuschner, G, Markart, P, Prasse, A, Schönfeld, N, Schupp, J C, Sitter, H, Müller-Quernheim, J, and Costabel, U

Subjects
610 Medicine & health
Published
2020
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