Patient eligibility for anti-fibrotic therapy in idiopathic pulmonary fibrosis can be altered by use of different sets of reference values for calculation of FVC percent predicted.
Antifibrotic drugs for idiopathic pulmonary fibrosis patients in England and Scotland are only available to those with FVC percent predicted (FVC%pred) less than or equal to 80%. The prescribing guidance does not state which set of reference values should be used and we show that a patient's FVC%pred can change by 4-6% depending on the choice of reference. We calculated FVC%pred for a group of 528 IPF patients using three different sets of reference values. 90% of patients with FVC%pred 80-85% calculated using European Community Coal and Steel (ECSC) reference values fall into the eligible range when NHANES reference values are used.
Department of Respiratory Medicine, Royal Free Hospital, Pond Street, London, NW3 2QG, United Kingdom. Electronic address: katieward@nhs.net.
Katie
K
Ward
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
Lydia
L
Spurr
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
Nina R
NR
Goldman
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
George A
GA
Margaritopoulos
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
Maria
M
Kokosi
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
Elizabetta
E
Renzoni
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
Felix
F
Chua
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom; NIHR Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom; Fibrosis Research Group, National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, Imperial College, London, SW7 2AZ, United Kingdom.
Toby M
TM
Maher
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
Simon
S
Ward
Interstitial Lung Disease Unit, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, United Kingdom.
Athol U
AU
Wells
D000368:Aged; D004739:England / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000208:ethnology / Q000628:therapy*; D008297:Male; D009749:Nutrition Surveys / Q000592:standards; D012016:Reference Values; D012129:Respiratory Function Tests / Q000379:methods; D012606:Scotland / Q000453:epidemiology; D014797:Vital Capacity / Q000502:physiology*
Idiopathic pulmonary fibrosis; Interstitial lung disease; Respiratory function tests