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Medical Research Council (MRC) Dyspnea Score as a Measure of Disease Progression in Patients With ILD Other Than IPF FREE TO VIEW

Hadeel Khadawardi, MD
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University of Western Ontario, London, ON, Canada

Chest. 2015;148(4_MeetingAbstracts):1020A. doi:10.1378/chest.2265860
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SESSION TITLE: Signs and Symptoms of Chest Diseases Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Objective: To investigate whether MRC dyspnea score is a predictor of disease progression in patients with ILD other than IPF.

METHODS: Methods: Sixty-five patients with ILD other than IPF were retrospectively studied. Seventy five percent of subjects were on immunosuppressive treatment, either corticosteroids and/or cytotoxic therapy. Baseline MRC dyspnea score (MRCDS; 0 to 5) and 3-month changes were considered. The endpoint was clinical progression within 17 months from baseline. Clinical progression was defined as either: > 10% absolute reduction in FVC percent predicted; >50 m decline in 6 minute walk distance (6MWD); hospitalization for respiratory causes; or death.

RESULTS: Results: Average follow-up was 11±4 months. During the observation period, 26 (40%) patients progressed, including 5 deaths. MRCDS at baseline was not significantly different between progressors and non-progressors. However, 3-month worsening of MRCDS was significantly more frequent in progressors (84%) than in non-progressors (23%) (p<0.0001). Worsening of MRCDS was a significant predictor of progression (HR 11.9, C.I. 4.4-41.8, p<0.0001), with 85% sensitivity and 77% specificity. MRC categorical change (from 0-3 to 4-5) predicted progression (HR 5.6, C.I. 2.5-12.5, p<0.0001) with improved specificity (92%) but worse sensitivity (58%). Gender, baseline age, BMI and DLCO did not predict clinical progression.

CONCLUSIONS: Conclusion: Our study shows that 3-month changes of MRCDS, but not baseline values, are significant predictors of clinical progression of ILD other than IPF.

CLINICAL IMPLICATIONS: Dyspnea is the main complain in patients with interstitial lung disease (ILD) and significantly affects quality of life. Medical Research Council (MRC) dyspnea score has been showed to be a reliable method to monitor disease progression in patients with ILD secondary to other causes. MRCDS reflects response to therapy and may be a very useful parameter to follow the clinical course of ILDs other than IPF.

DISCLOSURE: The following authors have nothing to disclose: Hadeel Khadawardi

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