Hypersensitivity Pneumonitis
Conditions
Keywords
hypersensitivity pneumonitis, pulmonary fibrosis, interstitial lung disease
Brief summary
EVITA is a multicentric Latin-American prospective cohort on chronic hypersensitivity pneumonitis. EVITA's objective is to identify phenotypes and/or endotypes associated with different disease trajectories measured primarily by forced vital capacity (FVC) during a 24 month follow-up period. Other secondary measures of disease progression will also be investigated such as imaging, time to death or lung transplantation, and patient-reported outcomes
Interventions
A comprehensive evaluation of the disease's extension, its impact on function, quality of life, and the search for phenotype/endotypes will be performed. The association between endotypes and disease progression will be tested.
Sponsors
Study design
Eligibility
Inclusion criteria
1. Adult outpatient subjects (18 years old or older) that fulfill the 2020 ATS/JRS/ALAT diagnostic criteria of HP of at least moderate confidence (70% confidence or more). 2. Willingness to undergo the evaluations proposed in this protocol 3. HP diagnosis within the last 24 months 4. Presence of radiological or histological fibrosis: 4.a. Radiological fibrosis consists of unequivocal fine or coarse reticulation with architectural lung distortion and/or traction bronchiectasis and/or honeycomb. 4.b. Unequivocal histopathological fibrosis evidenced on lung specimens
Exclusion criteria
1. Pregnancy 2. Presence of established connective tissue disease 3. Severe comorbidity impacting on the respiratory system as judged by the attending physician (ex. congestive heart failure, neoplasm, post-COVID-19 sequelae) 4. Use of supplemental oxygen at rest 5. Dyspnea mMRC 4 (too breathless to leave the house or breathless when dressing or undressing) 6. Unequivocal emphysematous pattern of HP on HRCT 7. Unequivocal pleuro-parenchymal fibroelastosis on the HRCT 8. Significant pulmonary arterial hypertension: 8.a. Signs of right ventricular failure by echodopplercardiogram or 8.b. Cardiac index \< 2L/min/m2 or right heart catheterism
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Variation in Forced Vital Capacity (FVC) as a continuous variable | 24 months |
Secondary
| Measure | Time frame |
|---|---|
| Variation in Computed Tomography Lung Densitometry | 24 months |
| Time to death or lung transplantation | 24 months |
| Acute exacerbation rate | 24 months |
| King´s Brief Interstitial Lung Disease Questionnaire (K-BILD) | 24 months |
Other
| Measure | Time frame |
|---|---|
| Variation in meters walked measured by the 6MWT | 24 months |
| Variation in the ratio dessaturation/meters-walked measured by 6MWT | 24 months |
| Variation in the dyspnea scores on mMRC scale | 24 months |
| Proportion of patients varying FVC >= 10% | 24 months |
Countries
Argentina, Brazil, Chile