Long-term monitoring of patients with fibrotic interstitial lung disease: A Canadian Thoracic Society Position Statement

Abstract

Longitudinal monitoring of patients with fibrotic interstitial lung disease (ILD) is essential to identifying disease progression and guiding management decisions. There are no evidence-based clinical practice guidelines to inform decision-making for the appropriate components and frequency of monitoring patients with fibrotic ILD. This position statement summarizes the key components of long-term monitoring of fibrotic ILD, including the appropriate frequency of monitoring, specific symptoms and comorbidities to consider, and the objective testing that should be routinely performed. Key messages based on scientific literature review and consensus from a panel of ILD experts are provided to guide clinical practice.

RÉSUMÉ

La surveillance longitudinale des patients atteints de fibrose pulmonaire interstitielle est essentielle pour déterminer la progression de la maladie et guider les décisions de prise en charge. Il n'existe pas de lignes directrices de pratique clinique fondées sur des données probantes pour éclairer la prise de décision concernant les composantes et la fréquence de la surveillance appropriées des patients atteints de fibrose pulmonaire interstitielle. Cet énoncé de position résume les éléments clés de la surveillance fibrose pulmonaire interstitielle à long terme, y compris la fréquence appropriée de la surveillance, les symptômes particuliers et les comorbidités à tenir en compte, ainsi que les tests objectifs qui devraient être effectués en routine. Des messages clés fondés sur une revue de la littérature scientifique et le consensus d'un panel d'experts en fibrose pulmonaire interstitielle sont présentés pour guider la pratique clinique.

Acknowledgments

The authors would like to thank the CTS and the Executive Committee of the Canadian Respiratory Guidelines Committee (CRGC) (Samir Gupta, Christopher Licskai, and Sanjay Mehta) for their thoughtful comments and input. We would also like to acknowledge with deep appreciation our Expert Peer Reviewers who made valuable contributions to the manuscript: André Cantin, MD, Université de Sherbrooke, Faculté de Médecine et des Sciences de la Santé, Sherbrooke, Québec, Canada; and Helen Jo, MD, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Editorial independence

The CTS ILD Assembly is accountable to the CTS CRGC and the CTS Board of Directors. The CTS ILD Assembly is functionally and editorially independent from any funding sources of the CTS and does not receive any direct funding from external sources. The CTS receives unrestricted grants that are combined into a central operating account to facilitate the knowledge translation activities of the CTS Assemblies. No funders played a role in the collection, review, analysis or interpretation of the scientific literature or in any decisions regarding the key messages presented in this document.

Disclosure statement

Members of the CTS ILD Assembly declared potential conflicts of interest at the time of appointment and these were updated throughout the process in accordance with the CTS Conflict of Interest Disclosure Policy. Individual member conflict of interest statements are posted at https://cts-sct.ca/guideline-library/.