Daily Home Spirometry: An Effective Tool for Detecting Progression in Idiopathic Pulmonary Fibrosis
Daily Home Spirometry: An Effective Tool for Detecting Progression in Idiopathic Pulmonary Fibrosis
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DOI：
10.1164/rccm.201511-2152oc
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发表时间：
2016-10-15
影响因子：
24.7
通讯作者：
Maher, Toby M.
中科院分区：
文献类型：
--
作者：
Russell, Anne-Marie;Adamali, Huzaifa;Maher, Toby M.
基本原理：最近的临床试验成功使得对特发性肺纤维化（IPF）疾病进展的早期和更敏感的终点的需求变得迫切。家庭肺功能测定允许更频繁地测量FVC比医院为基础的评估，因此提供了一个更细粒度的洞察IPF progression.Objectives的变化的机会：为了确定的可行性和可靠性，测量每日FVC在个人与IPF.Methods：与IPF受试者进行了手持肺量计和指导如何自我管理肺功能测定。受试者记录每日FEV 1和FVC，持续490天。临床评估和医院为基础的肺功能测定进行了6个月和12个月，结果数据收集3 years. Measures和主要结果：每日肺功能测定记录了50名受试者的中位数为279天（范围，13-490天）。研究期间有18例死亡。家庭肺功能测定显示与医院获得的读数有很好的相关性。FVC下降率对3个月时的结局和随后的死亡率具有高度预测性（危险比[FIR]，1.040; 95%置信区间[CI]，1.021-1.062; P
Rationale: Recent clinical trial successes have created an urgent need for earlier and more sensitive endpoints of disease progression in idiopathic pulmonary fibrosis (IPF). Domiciliary spirometry permits more frequent measurement of FVC than does hospital-based assessment, which therefore affords the opportunity for a more granular insight into changes in IPF progression.Objectives: To determine the feasibility and reliability of measuring daily FVC in individuals with IPF.Methods: Subjects with IPF were given handheld spirometers and instruction on how to self-administer spirometry. Subjects recorded daily FEVi and FVC for up to 490 days. Clinical assessment and hospital-based spirometry was undertaken at 6 and 12 months, and outcome data were collected for 3 years.Measurements and Main Results: Daily spirometry was recorded by 50 subjects for a median period of 279 days (range, 13-490 d). There were 18 deaths during the active study period. Home spirometry showed excellent correlation with hospital-obtained readings. The rate of decline in FVC was highly predictive of outcome and subsequent mortality when measured at 3 months (hazard ratio [FIR], 1.040; 95% confidence interval [CI], 1.021-1.062; P