TY - JOUR
T1 - A modified Delphi exercise in physician-perceived risk factors for drug-induced pneumotoxicity in patients with rheumatological disease
AU - PASSWRD participants
AU - Cartlidge, Manjit K.
AU - Brown, Kevin K.
AU - Chaudhuri, Nazia
AU - Corte, Tamera J.
AU - Dieudé, Phillipe
AU - John, Levin
AU - Kelly, Clive
AU - Khanna, Dinesh
AU - McRorie, Euan
AU - Nicol, Lisa
AU - Stewart, Gareth
AU - Walsh, Simon L.F.
AU - Wijsenbeek, Marlies
AU - Hirani, Nik
AU - Nunes, Hilario
AU - Assaya, Deborah
AU - Sehga, Sameep
AU - Stebbings, Simon M.
AU - Robles-Perez, Alejandro
AU - Crawshaw, Anjali
AU - Gudmundsson, Gunnar
AU - Blum, H. C.
AU - Crestani, Bruno
AU - Confalonieri, Paola
AU - Sebastiani, Marco
AU - Gabrielli, Armando
AU - Balestro, Elisabetta
AU - Kiyan, Esen
AU - Morovic-Vergles, Jadranka
AU - Berlengiero, Virginia
AU - Rivera-Ortega, Pilar
AU - Matsuda, Toshiaki
AU - Bernardino, Vera
AU - Saunders, Peter
AU - Marovic, Kristina Frketic
AU - Sulli, Alberto
AU - van der Lee, Ivo
AU - Manfredi, Andreina
AU - Al-farttoosi, Abdulla
AU - Campochiaro, Corrado
AU - Nossent, E. J.
AU - Iudici, Michele
AU - Ryerson, Christopher J.
AU - Grazzini, Silvia
AU - Derrett-Smith, Emma
AU - Parfrey, Helen
AU - MdC, Venero
AU - Waseda, Yuko
AU - Reza Beiga, Davide Mohammed
AU - Hysa, Elvis
AU - Toma, Claudia Lucia
AU - Delobbe, Alain
AU - Spencer, Lisa G.
AU - Godoy,
AU - Low, Su Ying
AU - Mogulkoc, Nesrin
AU - Kabasakal, Yasemin
AU - Perkovic, Dijana
AU - Ross, Alessandra Della
AU - Kalyoncu, Ali Fuat
AU - Solomon, Joshua J.
AU - Garzanova, Liudmila
AU - Rednic, Simona
AU - Busaid, Nasser Al
AU - Patil, Shital
AU - Juge, Pierre Antoine
AU - Foti, Rosario
AU - Rosato, Edoardo
AU - Campainha, Sergio
AU - Jones, Richard Mathew
AU - Cobilinschi, Claudia
AU - Kolb, Martin
AU - Gheorghiu, Ana Maria
AU - Highland, Kristin B.
AU - Luckhardt, Tracy
AU - Tomii, Keisuke
AU - Saiton, Shigeki
AU - Guillen, Alfredo
AU - Ceribelli, Angela
AU - Agrawal, Aditya
AU - Borie, Raphael
AU - Stewart, Gareth A.
AU - Grainger, Rebecca
AU - Antin-Ozerkis, Danielle
AU - Ramirez, Maria Teresa Rio
AU - Vikse, Jens
AU - Drakopanagiotakis, Fotio
AU - Lipchik, Randolph J.
AU - Castillo, Diego
AU - Garcia Martos, Álvaro
AU - Nicol, Lisa M.
AU - Gardiner, Philip V.
AU - Bilaceroglu, Semra
AU - Camus, Philippe
AU - Johannson, Kerri A.
AU - O’Beirne, Sarah L.
AU - Judge, Eoin P.
AU - Carty, Sara Madelaine
AU - Montoya, Sandra Fabiana
AU - Garcia Gonzalez, Estrella
AU - Chua, Felix
AU - Walker, Ulrich A.
AU - Naclerio, Caterina
AU - Devi, HJ Gayathri
AU - Castro, Horacio Matias
AU - Culver, Dr Emma L.
AU - Launay, David
AU - Davidsen, Jesper Rømhild
AU - Myall, Katherine J.
AU - Benucci, Maurizio
AU - Maher, Toby M.
AU - Radzikowska, Elżbieta
AU - Scarlata, Simone
AU - Chai, Gin Tsen
AU - Nunes, Mario Sergio
AU - Salinas, Mauricio
AU - Eiger, Glenn
AU - Amaral, Alexandre Franco
AU - Koduri, Gouri M.
AU - Baresic, Marko
AU - Turner, Alice M.
AU - Hajari Case, Amy
AU - Kalluri, Meena
AU - Izumi, Shinyu
AU - Keshavan, V.
AU - Conticini, Edoardo
AU - Brito de Araujo, Daniel
AU - Perch, Michael
AU - Jones, Mark G.
AU - Vicens-Zygmunt, Vanesa
AU - Balbir-Gurman, Alexandra
AU - Fretheim, Harvard
AU - Tanino, Yoshinori
AU - Papanikolaou, Ilias C.
AU - Dzhus, Marta
AU - Avdeev, Sergey
AU - Muller, Carolina
AU - Padilla, Maria L.
AU - Shifren, Adrian
AU - Wilsher, Margaret L.
AU - Fahim, Ahmed
AU - Patel, Divya C.
AU - Novelli, Luca
AU - Bennett, David
AU - Wuyts, Wim A.
AU - Cameli, Paolo
AU - Dhasmana, Devesh J.
AU - Carreira, Patricia E.
AU - Alfaro, Tiago
AU - Kah-Lai Leong, Carrie
AU - Mukherjee, Suranjan
AU - Ferreira, Pedro
AU - Russell, Tonya
AU - Selvi, Enrico
AU - Chaudhury, Nazia
AU - Selva-O’Callaghan, Albert
AU - Carbone, Roberto G.
AU - Bendstrup, Elisabeth
AU - López Miguel, Patricia
AU - Chaigne, Benjamin
AU - Hyldgaard, Charlotte
AU - Golla, Janardhana
AU - Chalmers, George W.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - 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.
AB - 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.
KW - Drug-induced interstitial lung disease
KW - Drug-induced pneumotoxicity
KW - Interstitial lung disease
KW - Pneumotoxicity
KW - Rheumatological drugs
UR - http://www.scopus.com/inward/record.url?scp=85208290842&partnerID=8YFLogxK
U2 - 10.1186/s12890-024-03287-0
DO - 10.1186/s12890-024-03287-0
M3 - Article
C2 - 39482644
AN - SCOPUS:85208290842
SN - 1471-2466
VL - 24
JO - BMC Pulmonary Medicine
JF - BMC Pulmonary Medicine
IS - 1
M1 - 547
ER -