In routine clinical practice, how do you operationally define ‘progression despite therapy’ in PPF to justify escalation to combination treatment?

ILD patients undergo regular monitoring with intervals based on concern for progression. In addition to symptom review, objective testing includes PFTs with spirometry and DLCO, 6-minute walk testing that provides information on distance walked, symptoms experienced, and whether or not the patient d...

This is really difficult. There's a balance between overreacting and waiting until you've lost significant lung function. The other thing to consider is that, at least in our practice, we will have a patient visit where they get testing such as physiology and chest imaging, and then we start a medic...

I think this is an interesting question because the possibility of combining antifibrotic therapies now makes “progression despite therapy” relevant in a way it was not before, but we still do not have an evidence-defined threshold for escalation.

If progression is real after looking at the trajector...