Monique Wapenaar

Daily home spirometry to detect early steroid treatment effects in newly treated pulmonary sarcoidosis

Prednisone is the mainstay of sarcoidosis treatment. However, prednisone treatment optimisation is warranted, since prolonged high-dose prednisone therapy is associated with burdensome and harmful side-effects [1, 2]. Early prednisone dose tapering has the potential to reduce side-effects. Gaining insight in the early treatment response can help to determine when tapering could be initiated. To date, there are no prospective studies that look at early treatment response to prednisone in sarcoidosis by monitoring clinical symptoms and daily patient-administered lung function. Therefore, we initiated a multicentre, prospective and observational study with daily home spirometry to detect early steroid treatment effects in newly treated pulmonary sarcoidosis (Dutch National Trial Register NTR4328; www.trialregister.nl/trialreg). The major treatment effect of prednisone on FVC is reached within 2 to 3 weeks in newly treated sarcoidosis patients http://ow.ly/3A3E30h5ZuT

Translation and validation of the King’s Brief Interstitial Lung Disease (K-BILD) questionnaire in French, Italian, Swedish, and Dutch:

No disease-specific instruments exist in Dutch, French, Italian, and Swedish to measure health status in idiopathic pulmonary fibrosis (IPF) and other interstitial lung diseases (ILDs). The King’s Brief Interstitial Lung Disease (K-BILD) is a 15-item validated questionnaire assessing health status in patients with ILD. The aim of this study was to translate and validate the K-BILD to French, Italian, Swedish, and Dutch versions. The K-BILD was translated following a forward–backward multistep procedure and tested in structured patient interviews. Subsequently, 195 outpatients with ILD were asked to complete K-BILD, St. George’s Respiratory Questionnaire (SGRQ), and Euroqol EQ-5D-5L (EQ5D), twice, 2 weeks apart. Internal consistency, concurrent validity, and repeatability were determined. No major difficulties occurred in the translation processes. The K-BILD was considered comprehensible and relevant by patients. One hundred seventy-six patients (108 IPF and 68 other ILDs) completed the translated K-BILD. Internal consistency was good for all K-BILD modules (Cronbach’s α 0.70–0.93). Concurrent validity of K-BILD was strong compared with SGRQ (r = −0.86) and EQ5D (r = 0.68), low with transfer capacity of the lung for carbon monoxide corrected for hemoglobin (r = 0.33) and with forced vital capacity (r = 0.35). The K-BILD and its domains were repeatable over 2 weeks; intraclass correlation coefficients were 0.86–0.93 (n = 159). Known groups validity showed K-BILD was able to discriminate between patients based on severity of disease. K-BILD’s validity and reliability for patients with IPF was similar to that of other ILDs. The French, Italian, Swedish, and Dutch translated K-BILD questionnaires were well-received by patients and demonstrated excellent validity comparable to the original English K-BILD.