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调查进行性纤维性间质性肺病(INSIGHTS-ILD)中的重要健康趋势:一项全国性前瞻性登记研究的原理、目的和设计。

Investigating significant health trends in progressive fibrosing interstitial lung disease (INSIGHTS-ILD): rationale, aims and design of a nationwide prospective registry.

机构信息

Department of Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), University Hospital, LMU Munich, Munich, Germany.

Center for Interstitial and Rare Lung Diseases, Pneumology Department, Ruhrlandklinik University Hospital, Duisburg-Essen University, Essen, Germany.

出版信息

BMC Pulm Med. 2023 Feb 11;23(1):64. doi: 10.1186/s12890-023-02333-7.

Abstract

BACKGROUND

The progressive course of pulmonary fibrosis (PPF) is observed with variable prevalence in different entities of fibrosing interstitial lung disease (fILD). PPF is characterised by worsening respiratory symptoms, declining lung function and increasing extent of fibrosis on high-resolution computer tomography. In Germany, data are limited on the characteristics and management of such patients.

METHODS/DESIGN: INSIGHTS-ILD is a prospective observational longitudinal registry designed to describe characteristics, management and course of newly diagnosed (incident) and prevalent patients with fILD on the long term. The registry uses a non-probability sampling approach to collect data on characteristics, therapeutic interventions, health-related quality of life and health economic parameters. It is planned to include 900 patients in ambulatory care in about 30 expert sites over three years. The study has been initiated in December 2021, and currently (January 2023) follows 360 patients.

DISCUSSION

The registry is expected to provide much-needed data on the characteristics, management, and trajectories of patients fILD in Germany. The start of the study comes at a time when new treatment options are available for PPF. We hypothesize that PPF represents a broad clinical phenotype that is differentially influenced by inflammatory and fibrotic pathomechanisms that need to be treated with anti-inflammatory and/or anti-fibrotic treatment strategies. This registry will allow comparisons with other countries. Gap analyses based on current guidelines for management of these patients will be possible. Trial registration DRKS00027389 (registered on 7.12.2021), BfArM NIS 7562.

摘要

背景

在不同的纤维化间质性肺疾病(fILD)实体中,都观察到了肺纤维化(PPF)的进行性病程,其具有不同的流行率。PPF 的特征是呼吸症状恶化、肺功能下降以及高分辨率计算机断层扫描上纤维化程度增加。在德国,关于此类患者的特征和管理的数据有限。

方法/设计:INSIGHTS-ILD 是一项前瞻性观察性纵向登记研究,旨在长期描述新诊断(新发)和现患 fILD 患者的特征、管理和病程。该登记使用非概率抽样方法收集特征、治疗干预、健康相关生活质量和健康经济学参数的数据。计划在三年内于大约 30 个专家站点纳入 900 名门诊患者。该研究于 2021 年 12 月启动,目前(2023 年 1 月)随访了 360 名患者。

讨论

该登记预计将提供德国 fILD 患者特征、管理和病程的急需数据。研究开始时,新的治疗选择已经可用于 PPF。我们假设 PPF 代表一种广泛的临床表型,其受炎症和纤维化发病机制的影响不同,需要用抗炎和/或抗纤维化治疗策略来治疗。该登记将允许与其他国家进行比较。基于这些患者管理的当前指南进行差距分析将成为可能。试验注册 DRKS00027389(于 2021 年 12 月 7 日注册),BfArM NIS 7562。

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