Hospital de Rehabilitación Respiratoria "María Ferrer", Buenos Aires, Argentina.
Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico.
Arch Bronconeumol. 2022 Dec;58(12):794-801. doi: 10.1016/j.arbres.2022.04.007. Epub 2022 Jun 4.
Idiopathic pulmonary fibrosis (IPF) is a progressive, irreversible and frequently fatal disease. Currently there are national and multinational registries in Europe, United States, Australia and China to better understand the magnitude of the problem and the characteristics of the IPF patients. However, there are no national or regional registries in Latin America, so the objective of this study was to carry out a Latin American registry that would allow the identification of IPF patients in our region.
A system consisting of 3 levels of control was designed, ensuring that patients met the diagnostic criteria for IPF according to international guidelines ATS/ERS/ALAT/JRS 2011. Demographic, clinical, serological, functional, tomographic, histological and treatment variables were recorded through a digital platform.
761 IPF patients from 14 Latin American countries were included for analysis, 74.7% were male, with a mean age of 71.9+8.3 years. In general there was a long period of symptoms before definitive diagnosis (median 1 year). In functional tests, an average reduction of FVC (70.9%) and DLCO (53.7%) was detected. 72% received at least one antifibrotic drug (pirfenidone or nintedanib) and 11.2% of the patients had an acute exacerbation, of which 38 (45.2%) died from this cause.
Like other registries, we found that there is difficulty in the recognition and excessive delay in the diagnosis of IPF in Latin America. Most of the patients in REFIPI received antifibrotics; these were well tolerated and associated with fewer adverse events than those reported in clinical trials.
特发性肺纤维化(IPF)是一种进行性、不可逆转且常致命的疾病。目前,欧洲、美国、澳大利亚和中国都有国家和多国登记处,以便更好地了解该问题的严重程度和 IPF 患者的特征。然而,拉丁美洲没有国家或地区登记处,因此本研究的目的是开展一项拉丁美洲登记处,以确定我们地区的 IPF 患者。
设计了一个由 3 级控制组成的系统,以确保患者符合国际指南 ATS/ERS/ALAT/JRS 2011 的 IPF 诊断标准。通过数字平台记录人口统计学、临床、血清学、功能、断层扫描、组织学和治疗变量。
纳入了来自 14 个拉丁美洲国家的 761 名 IPF 患者进行分析,74.7%为男性,平均年龄为 71.9+8.3 岁。一般来说,在明确诊断之前有很长一段时间的症状(中位数为 1 年)。在功能测试中,平均 FVC(70.9%)和 DLCO(53.7%)下降。72%至少接受了一种抗纤维化药物(吡非尼酮或尼达尼布)治疗,11.2%的患者发生了急性加重,其中 38 例(45.2%)因该原因死亡。
与其他登记处一样,我们发现拉丁美洲在识别和诊断 IPF 方面存在困难且存在过度延迟。REFIPI 中的大多数患者接受了抗纤维化治疗;这些药物耐受性良好,与临床试验报告的不良事件相比更少。