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Safety and Effectiveness of Mycophenolate Mofetil in Interstitial Lung Diseases: Insights from a Machine Learning Radiographic Model.

Introduction: Treatment of interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF) often includes systemic corticosteroids. Use of steroid-sparing agents is amenable to avoid potential side effects. Methods: Functional indices and high-resolution computed tomography (HRCT) p...

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Published in:Respiration Vol. 101; no. 3; pp. 262 - 272
Main Authors: Karampitsakos, Theodoros, Kalogeropoulou, Christina, Tzilas, Vasilios, Papaioannou, Ourania, Kazantzi, Alexandra, Koukaki, Evangelia, Katsaras, Matthaios, Bouros, Evangelos, Tsiri, Panagiota, Tsirikos, Georgios, Zarkadi, Eirini, Ntoulias, Nikolaos, Sotiropoulou, Vasilina, Efthymiou, Panagiotis, Chrysikos, Serafeim, Malakounidou, Elli, Sampsonas, Fotios, Bouros, Demosthenes, Tzouvelekis, Argyrios
Format: diagnostic images pictorial research tables/charts Journal Article
Published: Karger AG Mar2022
Online Access:View this record in EBSCOhost
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      dt: Mar2022
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      pub: Karger AG
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        10.1159/000519215
        155555467
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        atl: Safety and Effectiveness of Mycophenolate Mofetil in Interstitial Lung Diseases: Insights from a Machine Learning Radiographic Model.
      aug:
        au:
          Karampitsakos, Theodoros
          Kalogeropoulou, Christina
          Tzilas, Vasilios
          Papaioannou, Ourania
          Kazantzi, Alexandra
          Koukaki, Evangelia
          Katsaras, Matthaios
          Bouros, Evangelos
          Tsiri, Panagiota
          Tsirikos, Georgios
          Zarkadi, Eirini
          Ntoulias, Nikolaos
          Sotiropoulou, Vasilina
          Efthymiou, Panagiotis
          Chrysikos, Serafeim
          Malakounidou, Elli
          Sampsonas, Fotios
          Bouros, Demosthenes
          Tzouvelekis, Argyrios
        affil: Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece
      sug:
        subj:
          Lung Diseases, Interstitial Drug Therapy
          Mycophenolate Mofetil Therapeutic Use
          Mycophenolate Mofetil Pharmacodynamics
          Patient Safety
          Drug Efficacy
          Machine Learning
          Human
          Tomography, X-Ray Computed Methods
          After Care
          Radiologists
          Data Analysis Software
          Male
          Female
          Middle Age
          Confidence Intervals
          Descriptive Statistics
          Intraclass Correlation Coefficient
          Middle Aged: 45-64 years
          Male
          Female
      ab: Introduction: Treatment of interstitial lung diseases (ILDs) other than idiopathic pulmonary fibrosis (IPF) often includes systemic corticosteroids. Use of steroid-sparing agents is amenable to avoid potential side effects. Methods: Functional indices and high-resolution computed tomography (HRCT) patterns of patients with non-IPF ILDs receiving mycophenolate mofetil (MMF) with a minimum follow-up of 1 year were analyzed. Two independent radiologists and a machine learning software system (Imbio 1.4.2.) evaluated HRCT patterns. Results: Fifty-five (n = 55) patients were included in the analysis (male: 30 [55%], median age: 65.0 [95% CI: 59.7–70.0], mean forced vital capacity %predicted [FVC %pred.] ± standard deviation [SD]: 69.4 ± 18.3, mean diffusing capacity of lung for carbon monoxide %pred. ± SD: 40.8 ± 14.3, hypersensitivity pneumonitis: 26, connective tissue disease-ILDs [CTD-ILDs]: 22, other ILDs: 7). There was no significant difference in mean FVC %pred. post-6 months (1.59 ± 2.04) and 1 year (−0.39 ± 2.49) of treatment compared to baseline. Radiographic evaluation showed no significant difference between baseline and post-1 year %ground glass opacities (20.0 [95% CI: 14.4–30.0] vs. 20.0 [95% CI: 14.4–25.6]) and %reticulation (5.0 [95% CI: 2.0–15.6] vs. 7.5 [95% CI: 2.0–17.5]). A similar performance between expert radiologists and Imbio software analysis was observed in assessing ground glass opacities (intraclass correlation coefficient [ICC] = 0.73) and reticulation (ICC = 0.88). Fourteen patients (25.5%) reported at least one side effect and 8 patients (14.5%) switched to antifibrotics due to disease progression. Conclusion: Our data suggest that MMF is a safe and effective steroid-sparing agent leading to disease stabilization in a proportion of patients with non-IPF ILDs. Machine learning software systems may exhibit similar performance to specialist radiologists and represent fruitful diagnostic and prognostic tools.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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