The annual meeting of the American College of Chest Physicians was held this year from Oct. 8 to 11 in Honolulu and attracted participants from around the world, including specialists and heath care professionals focused on pulmonary medicine, critical care, and sleep medicine. The conference featured presentations focusing on clinical updates in thoracic medicine.
In one study, Christine Lambert, M.D., of the University of Minnesota in Minneapolis, and colleagues found that the use of geospatial techniques can help identify the characteristics and distribution of current and former smokers who may be eligible for lung cancer screening.
The authors created a model that integrated smoking prevalence survey data, modeled smoking histories, and demographic census data to determine the number of people within a census tract likely to be eligible for lung cancer screening. The researchers estimated 29.3 million individuals are eligible for lung cancer screening: 14.5 million current smokers and 14.8 million former smokers. An analysis of the distance between census tracts and the nearest screening facility participating in the American College of Radiology National Radiology Data Registry, showed that about 15 percent of individuals live at least 20 minutes from a screening facility. There were large variations noted by state and within states in the density of individuals estimated to be eligible for screening and the distance they would need to travel for screening.
“This information can be used to direct specialized outreach on screening and smoking cessation to certain populations and help health care systems and public health programs plan for the placement of lung cancer screening resources in areas of greatest need,” Lambert said.
In another study, Linda Pham, D.O., of Riverside Community Hospital in California, and colleagues found that patients with both asthma and eosinophilic esophagitis present to the hospital at an earlier age than patients with just one of the conditions.
The authors performed a retrospective cross-sectional study of adults presenting to the hospital with asthma and eosinophilic esophagitis between 2016 and 2021 across 185 U.S. hospitals (3,678,812 patients with asthma and 5,823 patients with eosinophilic esophagitis). The researchers found that patients who had both eosinophilic esophagitis and asthma presented earlier in age (about five years younger) to the hospital than patients with just one of these diseases. In addition, 4 percent of hospital encounters (emergency department and inpatient admissions) were for asthma.
“Doctors can consider that patients who have one atopic condition such as asthma may have another, such as eosinophilic esophagitis. If patients do have multiple atopic conditions, doctors can be cognizant of the possibility that the patient may be more susceptible to an exacerbation that may lead their patients to seek emergency treatment,” Pham said. “If doctors can make patients aware of this possibility, patients can pay better attention to their symptoms and seek appropriate help if needed.”
Andrew Limper, M.D., of the Mayo Clinic College of Medicine in Rochester, Minnesota, and colleagues found that a lower dose of the antifibrotic medication nintedanib (100 mg twice daily), used to treat idiopathic pulmonary fibrosis (IPF), may be associated with favorable clinical outcomes.
The authors used the OptumLabs Data Warehouse, a claims-based dataset, to identify patients with IPF treated with nintedanib at 150 mg twice daily compared with 100 mg twice daily. A 1:1 propensity score-matched cohort of 346 individuals in each dosing group was developed. The researchers found that patients with IPF who were receiving nintedanib at 100 mg twice a day had equivalent rates of hospitalization and equivalent mortality to those receiving the traditional dosing of 150 mg twice a day.
“These findings will need to be confirmed and expanded with additional observational and prospective studies,” Limper said. “Until additional data are available, we still recommend beginning patients with IPF on full dose nintedanib at 150 mg twice daily. However, patients that are intolerant of these higher doses due to side effects may have dose reduction to the 100 mg twice daily dosing schedule.”
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