التهاب الرئة التحسسي الليفي في رئة مربي الطيور عندما لم يُثبِّت العلاج المثبط للمناعة وظيفة الرئة

References

DOI: 10.1111/resp.14847

Patients with HP may also display features of fibrosis, including reticulation, traction bronchiectasis and honeycombing (Figure 2B).

Recently published international diagnostic guidelines recommend HP classification into fibrotic or nonfibrotic phenotypes based on the presence or absence of radiological and/or histopathological fibrosis, supported by the observation that pulmonary fibrosis conveys important prognostic and treatment implications.

In such cases, there is good evidence for the introduction of antifibrotic therapy, as supported by the ATS/ERS/JRS/ALAT clinical guidelines for PPF.

Antifibrotic agent nintedanib is approved for HP patients with progressive fibrotic disease in Australia, but is not yet funded for indications other than IPF in New Zealand.

The INBUILD trial recruited patients with progressive fibrosing ILDs other than IPF (including fibrotic HP), demonstrating reduction in the rate of FVC decline in the nintedanib arm compared to placebo at 52 weeks, with a similar efficacy to IPF.