Longitudinal Comparison Of Pulmonary Lung Functions In Asbestos-Related Interstitial Lung Diseases With Or Without A Radiological Uip Pattern

SESSION TITLE: Diffuse Lung Disease Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: October 18-21, 2020 PURPOSE: Asbestos exposure may lead to interstitial lung diseases with radiologic findings similar to those of subjects with Idiopathic Pulmonary Fibrosis (IPF), with a Usual Interstitial Pneumonia (UIP) pattern, as well as parenchymal fibrous bands and semi-circular lines. Although asbestosis with classical patterns of UIP can lead to respiratory failure, its natural history in terms of pulmonary function is not well known. Primary objective: To compare the change in forced vital capacity (FVC) at 1 year and 4 years after diagnosis between patients with asbestosis with and without a UIP pattern. Secondary objective: To compare the change in diffusion capacity of carbon monoxide (DLCO), forced expiratory volume in one second (FEV1) and total lung capacity (TLC) at 1 and 4 years after diagnosis between patients with asbestosis with and without a UIP pattern. METHODS: We performed a retrospective cohort study of patients diagnosed with asbestosis by the Quebec Worker Compensation Board (QWCB), between January 2017 and December 2019. Patients were included if they showed an interstitial lung disease attributed to asbestos exposure and had underwent at least 2 spirometries, at baseline and at 1- or 4-year follow-up. Patients with and without UIP pattern were identified. Patients demographics, comorbidities, computed tomography findings and lung function test results were recorded. The difference in FVC between baseline, 1-year follow up and 4-year follow up was compared between the UIP-asbestosis cohort and the non-UIP-asbestosis cohort. RESULTS: Ninety nine patients were included: 40 with UIP-asbestosis, 59 with non-UIP-asbestosis. FVC decline at 1 year was 217.5ml in UIP-asbestosis vs 8.6ml in non-UIP-asbestosis (p=0.06). FVC decline at 4 years was 396.3ml in UIP-asbestosis vs 74.8ml in non-UIP-asbestosis (p<0.001). The progression of dyspnea at 4 years in the UIP-asbestosis cohort was of 0,97 point on the MRC scale and was of 0,33 point in the non-UIP-asbestosis cohort (p=0,003). Other pulmonary function parameters were similar between the two cohorts. CONCLUSIONS: In subjects with asbestosis, a radiological UIP pattern is associated with a greater decline in FVC over 4 years. This is similar to the unfavorable physiologic decline associated with a UIP pattern in other types of interstitial lung diseases. CLINICAL IMPLICATIONS: Recently, we have seen the clinical utility of antifibrotic agents beyond IPF, particularly in progressive fibrosing interstitial lung diseases. Therefore, by identifying patients with asbestos-related interstitial lung disease that might progress sooner, we could consider using antifibrotic agents to slow their functional decline. DISCLOSURES: speaker bureau relationship with GSK Pharma Canada Please note: $5001 - $20000 Added 04/08/2020 by Andre Cartier, source=Web Response, value=Honoraria Advisory Committee Member relationship with Novartis Pharma Canada Please note: $1001 - $5000 Added 04/07/2020 by Andre Cartier, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with Merck Frosst Pharma Canada Please note: $1001 - $5000 Added 04/07/2020 by Andre Cartier, source=Web Response, value=Honoraria No relevant relationships by Catherine Lemiere, source=Web Response No relevant relationships by Emilie Millaire, source=Web Response