HRCT in Idiopathic Pulmonary Fibrosis Diagnosis and Prognosis

HRCT in Idiopathic Pulmonary Fibrosis: Diagnosis and Prognosis § Analysis of HRCT scans from patients enrolled in a randomized study of IFN g (n = 315) § Core panel of 3 thoracic radiologists conducted blinded reviews of baseline HRCT scans originally read by study site radiologists § HRCT diagnoses of core panel compared with those of study site radiologists § Baseline clinical, physiologic, and HRCT findings evaluated to identify predictors of mortality Lynch DA. Am J Respir Crit Care Med. 2005; 172: 488 -493. *Click above link for abstract

Imaging Diagnosis of IPF Core Radiologists Diagnosis of first 2 readers Consensus diagnosis 256 (81. 3%) 283 (89. 9%) Inconsistent with IPF 15 (4. 8%) 30 (9. 5%) Lack of agreement 44 (14%) 2 (0. 6%) Consistent with IPF Lynch DA. Am J Respir Crit Care Med. 2005; 172: 488 -493. *Click above link for abstract

Likelihood of Mortality Multivariate Analysis of Baseline Risk Factors Hazard Ratio** (95% Cl) P-value* HRCT overall disease extent score 2. 71 (1. 61– 4. 55) < 0. 0001 Baseline % predicted DLCO 0. 94 (0. 90– 0. 98) 0. 004 Randomization assignment to IFN g-1 b 0. 53 (0. 28– 0. 99) 0. 04 Baseline Risk Factor * The P-value is from the Wald chi-square test, stratifying by smoking status ** The ratio is calculated by Cox proportional hazards model, stratifying by smoking status Lynch DA. Am J Respir Crit Care Med. 2005; 172: 488 -493. *Click above link for abstract

IFN g-1 b Therapy in IPF: A Meta-analysis Included Studies Source Ziesche, et al Antoniou, et al Raghu, et al Active Treatment n Control Treatment n Followup (years) IFN g-1 b 200 g TIW 9 Placebo 9 5 0. 1796 27 Colchicine + Prednisolone 10 mg QD 15 1. 5 0. 1618 IFN g-1 b 200 g TIW + 162 Prednisolone 7. 5 mg QD Colchicine + Prednisolone 7. 5 mg QD 168 1. 5 0. 5898 IFN g-1 b 200 g TIW + Prednisolone 10 mg QD Bajwa EK, et al. Chest. 2005; 128: 203 -206. *Click above link for abstract HR

Effect of IFN g-1 b Treatment on Survival Raghu, et al. 2004 Antoniou, et al. 2003 Ziesche, et al. 2002 Pooled result -8 -6 -4 -2 0 2 4 6 Natural Log of Hazard Ratio Pooled Hazard Ratio = 0. 418 (0. 253– 0. 690); P = 0. 0003 Bajwa EK, et al. Chest. 2005; 128: 203 -206. *Click above link for abstract 8

Effect of IFN g-1 b Treatment on Survival Hazard Ratio (95% CI) P-value 6 months 0. 0046 (-0. 0364– 0. 0456) 0. 82 12 months 0. 0861 (0. 0244– 0. 1478) < 0. 0063 18 months 0. 1682 (0. 1065– 0. 2299) < 0. 0001 24 months 0. 2652 (0. 1652– 0. 3652) < 0. 0001 Bajwa EK, et al. Chest. 2005; 128: 203 -206. *Click above link for abstract