Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/35553
Title: Implications of the 2022 lung function update and GLI global reference equations among patients with interstitial lung disease.
Austin Authors: Li, Andrew;Teoh, Alan;Troy, Lauren;Glaspole, Ian;Wilsher, Margaret L;de Boer, Sally;Wrobel, Jeremy;Moodley, Yuben P;Thien, Francis;Gallagher, Henry;Galbraith, Michelle;Chambers, Daniel C;Mackintosh, John;Goh, Nicole S L ;Khor, Yet Hong;Edwards, Adrienne;Royals, Karen;Grainge, Christopher;Kwan, Benjamin;Keir, Gregory J;Ong, Chong;Reynolds, Paul N;Veitch, Elizabeth;Chai, Gin Tsen;Ng, Ziqin;Tan, Geak Poh;Jackson, Dan;Corte, Tamera;Jo, Helen
Affiliation: Department of Medicine, Respiratory Service, Woodlands Health, Singapore.;Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.;Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.;Department of Respiratory and Sleep Medicine, Westmead Hospital, Sydney, New South Wales, Australia.
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Alfred Hospital, Melbourne, Victoria, Australia.
Respiratory Services, Auckland District Health Board, Auckland, New Zealand.
Green Lane Respiratory Services, Auckland City Hospital, Auckland, New Zealand.
Department of Respiratory Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.;Department of Medicine, University of Notre Dame Australia, Fremantle, Perth, Australia.
Department of Respiratory Medicine, Eastern Health and Monash University, Box Hill, Victoria, Australia.
Waikato Hospital, Hamilton, New Zealand.
Queensland Lung Transplant Service, The Prince Charles Hospital, Chermside, Queensland, Australia.;Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.
Respiratory and Sleep Medicine
Institute for Breathing and Sleep, Monash University, Melbourne, Victoria, Australia.;Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.;Respiratory Research@ALfred, Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Respiratory Department, Christchurch Hospital, Christchurch, Canterbury, New Zealand.
Department for Health and Ageing, Respiratory Nursing Service, Adelaide, South Australia, Australia.
University of Newcastle, Callaghan, New South Wales, Australia.
Department of Respiratory and Sleep Medicine, Sutherland Hospital, Caringbah, New South Wales, Australia.
University of Queensland, St Lucia, Queensland, Australia.
Department of Respiratory and Sleep Medicine, St Vincent's Hospital Sydney, Darlinghurst, New South Wales, Australia.
Department of Respiratory Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia.
Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore.
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.;Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Issue Date: 16-Oct-2024
Date: 2024
Publication information: Thorax 2024-10-16; 79(11)
Abstract: 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. 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. 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. 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.
URI: https://ahro.austin.org.au/austinjspui/handle/1/35553
DOI: 10.1136/thorax-2024-221813
ORCID: 0000-0003-1516-3454
0000-0002-5254-4144
0000-0002-5434-9342
0000-0003-0758-6895
Journal: Thorax
Start page: 1024
End page: 1032
PubMed URL: 39317451
ISSN: 1468-3296
Type: Journal Article
Subjects: Connective tissue disease associated lung disease
Idiopathic pulmonary fibrosis
Interstitial Fibrosis
Pulmonary vasculitis
Rare lung diseases
Lung Diseases, Interstitial/physiopathology
Vital Capacity/physiology
Forced Expiratory Volume/physiology
Appears in Collections:Journal articles

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