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Article ; Online: A 53-Year-Old Woman With Dyspnea, Wheezing, and Irreversible Airway Obstruction.

Belloli, Elizabeth / Konopka, Kristine / Myers, Jeffrey / Hyzy, Robert

2020 Volume 157, Issue 6, Page(s) e189–e192

Abstract: Case presentation: A previously healthy 53-year-old woman with 4 months of dyspnea and subjective wheezing presented to pulmonary clinic for a second opinion. Her medical history included hypertension, obesity, and OSA. She had been hospitalized 3 ... ...

Abstract	Case presentation: A previously healthy 53-year-old woman with 4 months of dyspnea and subjective wheezing presented to pulmonary clinic for a second opinion. Her medical history included hypertension, obesity, and OSA. She had been hospitalized 3 months prior at an outside hospital for evaluation of these symptoms. She had never smoked. She was a retired teacher and previously served as a pet nanny to dogs and cats. She denied antecedent respiratory infection or environmental exposure before the onset of her symptoms. Current medications included budesonide-formoterol, tiotropium, loratadine, and montelukast. She did not experience significant change in symptoms with bronchodilators or corticosteroid treatment.
MeSH term(s)	Airway Obstruction/complications ; Airway Obstruction/diagnosis ; Airway Obstruction/physiopathology ; Diagnosis, Differential ; Dyspnea/diagnosis ; Dyspnea/etiology ; Dyspnea/physiopathology ; Female ; Forced Expiratory Volume ; Humans ; Middle Aged ; Respiratory Sounds ; Tomography, X-Ray Computed
Language	English
Publishing date	2020-06-06
Publishing country	United States
Document type	Case Reports
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2019.11.014
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Article ; Online: Claims-Based ICU Research: Learning From Imperfect Data.

Prescott, Hallie C / Belloli, Elizabeth A

Critical care medicine

2017 Volume 45, Issue 7, Page(s) 1263–1264

MeSH term(s)	Critical Care ; Humans ; Intensive Care Units ; Medicare ; Respiration, Artificial ; United States
Language	English
Publishing date	2017-05-22
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000002396
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Article ; Online: Pamrevlumab for Idiopathic Pulmonary Fibrosis: The ZEPHYRUS-1 Randomized Clinical Trial.

Raghu, Ganesh / Richeldi, Luca / Fernández Pérez, Evans R / De Salvo, Maria Cristina / Silva, Rafael S / Song, Jin Woo / Ogura, Takashi / Xu, Zuo Jun / Belloli, Elizabeth A / Zhang, Xueping / Seid, Lorilyn L / Poole, Lona

JAMA

2024

Abstract: Importance: Current treatments for idiopathic pulmonary fibrosis slow the rate of lung function decline, but may be associated with adverse events that affect medication adherence. In phase 2 trials, pamrevlumab (a fully human monoclonal antibody that ... ...

Abstract	Importance: Current treatments for idiopathic pulmonary fibrosis slow the rate of lung function decline, but may be associated with adverse events that affect medication adherence. In phase 2 trials, pamrevlumab (a fully human monoclonal antibody that binds to and inhibits connective tissue growth factor activity) attenuated the progression of idiopathic pulmonary fibrosis without substantial adverse events. Objective: To assess the efficacy and safety of pamrevlumab for patients with idiopathic pulmonary fibrosis. Design, setting, and participants: Phase 3 randomized clinical trial including 356 patients aged 40 to 85 years with idiopathic pulmonary fibrosis who were not receiving antifibrotic treatment with nintedanib or pirfenidone at enrollment. Patients were recruited from 117 sites in 9 countries between July 18, 2019, and July 29, 2022; the last follow-up encounter occurred on August 28, 2023. Interventions: Pamrevlumab (30 mg/kg administered intravenously every 3 weeks; n = 181) or placebo (n = 175) for 48 weeks. Main outcomes and measures: The primary outcome was absolute change in forced vital capacity (FVC) from baseline to week 48. There were 5 secondary outcomes (including time to disease progression, which was defined as a decline of ≥10% in predicted FVC or death). The exploratory outcomes included patient-reported symptoms. Adverse events were reported. Results: Among 356 patients (mean age, 70.5 years; 258 [72.5%] were men; 221 [62.1%] were White), 277 (77.8%) completed the trial. There was no significant between-group difference for absolute change in FVC from baseline to week 48 (least-squares mean, -260 mL [95% CI, -350 to -170 mL] in the pamrevlumab group vs -330 mL [95% CI, -430 to -230 mL] in the placebo group; mean between-group difference, 70 mL [95% CI, -60 to 190 mL], P = .29). There were no significant between-group differences in any of the secondary outcomes or in the patient-reported outcomes. In the pamrevlumab group, there were 160 patients (88.4%) with treatment-related adverse events and 51 patients (28.2%) with serious adverse events vs 151 (86.3%) and 60 (34.3%), respectively, in the placebo group. During the study, 23 patients died in each group (12.7% in the pamrevlumab group vs 13.1% in the placebo group). Conclusions and relevance: Among patients with idiopathic pulmonary fibrosis treated with pamrevlumab or placebo, there was no statistically significant between-group difference for the primary outcome of absolute change in FVC from baseline to week 48. Trial registration: ClinicalTrials.gov Identifier: NCT03955146.
Language	English
Publishing date	2024-05-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2024.8693
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Article ; Online: Spirometry States the Obvious: Recognizing Bronchiolitis Obliterans Syndrome Early after Hematopoietic Cell Transplantation.

Belloli, Elizabeth A / Lama, Vibha N

Annals of the American Thoracic Society

2016 Volume 13, Issue 11, Page(s) 1883–1884

MeSH term(s)	Bronchiolitis Obliterans ; Hematopoietic Stem Cell Transplantation ; Humans ; Lung Transplantation ; Spirometry
Language	English
Publishing date	2016-11-05
Publishing country	United States
Document type	Editorial ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.201608-645ED
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Article ; Online: Effects of nintedanib by inclusion criteria for progression of interstitial lung disease.

Maher, Toby M / Brown, Kevin K / Kreuter, Michael / Devaraj, Anand / Walsh, Simon L F / Lancaster, Lisa H / Belloli, Elizabeth A / Padilla, Maria / Behr, Juergen / Goeldner, Rainer-Georg / Tetzlaff, Kay / Schlenker-Herceg, Rozsa / Flaherty, Kevin R

The European respiratory journal

2022 Volume 59, Issue 2

Abstract: Background: The INBUILD trial investigated nintedanib : Methods: Subjects had a fibrosing ILD other than idiopathic pulmonary fibrosis and met the following criteria for ILD progression within the 24 months before screening despite management deemed ... ...

Abstract	Background: The INBUILD trial investigated nintedanib Methods: Subjects had a fibrosing ILD other than idiopathic pulmonary fibrosis and met the following criteria for ILD progression within the 24 months before screening despite management deemed appropriate in clinical practice: Group A, relative decline in FVC ≥10% predicted; Group B, relative decline in FVC ≥5-<10% predicted with worsened respiratory symptoms and/or increased extent of fibrosis on high-resolution computed tomography (HRCT); Group C, worsened respiratory symptoms and increased extent of fibrosis on HRCT only. Results: In the placebo group, the rates of FVC decline over 52 weeks in Groups A, B and C, respectively, were -241.9, -133.1 and -115.3 mL per year in the overall population (p=0.0002 for subgroup-by-time interaction) and -288.9, -156.2 and -100.1 mL per year among subjects with a usual interstitial pneumonia (UIP)-like fibrotic pattern on HRCT (p=0.0005 for subgroup-by-time interaction). Nintedanib had a greater absolute effect on reducing the rate of FVC decline in Group A than in Group B or C. However, the relative effect of nintedanib Conclusions: The inclusion criteria used in the INBUILD trial, based on FVC decline or worsening of symptoms and extent of fibrosis on HRCT, were effective at identifying patients with progressive fibrosing ILDs. Nintedanib reduced the rate of decline in FVC across the subgroups based on the inclusion criteria related to ILD progression.
MeSH term(s)	Disease Progression ; Humans ; Idiopathic Pulmonary Fibrosis/drug therapy ; Indoles ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/drug therapy ; Protein Kinase Inhibitors ; Vital Capacity
Chemical Substances	Indoles ; Protein Kinase Inhibitors ; nintedanib (G6HRD2P839)
Language	English
Publishing date	2022-02-03
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/13993003.04587-2020
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Article ; Online: Update in Interstitial Lung Disease 2014.

Belloli, Elizabeth A / Martinez, Fernando J / Flaherty, Kevin R

American journal of respiratory and critical care medicine

2015 Volume 192, Issue 5, Page(s) 538–543

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Doxycycline/therapeutic use ; Enzyme Inhibitors/therapeutic use ; Humans ; Idiopathic Pulmonary Fibrosis/diagnosis ; Idiopathic Pulmonary Fibrosis/drug therapy ; Idiopathic Pulmonary Fibrosis/metabolism ; Immunosuppressive Agents/therapeutic use ; Indoles/therapeutic use ; Lung Diseases, Interstitial/diagnosis ; Lung Diseases, Interstitial/drug therapy ; Lung Diseases, Interstitial/metabolism ; Lymphangioleiomyomatosis/diagnosis ; Lymphangioleiomyomatosis/drug therapy ; Lymphangioleiomyomatosis/metabolism ; Pyridones/therapeutic use ; Sarcoidosis, Pulmonary/diagnosis ; Sarcoidosis, Pulmonary/drug therapy ; Sarcoidosis, Pulmonary/metabolism ; Sirolimus/therapeutic use ; Smoking ; Tomography, X-Ray Computed ; Tumor Necrosis Factor-alpha/antagonists & inhibitors
Chemical Substances	Anti-Bacterial Agents ; Anti-Inflammatory Agents, Non-Steroidal ; Enzyme Inhibitors ; Immunosuppressive Agents ; Indoles ; Pyridones ; Tumor Necrosis Factor-alpha ; pirfenidone (D7NLD2JX7U) ; nintedanib (G6HRD2P839) ; Doxycycline (N12000U13O) ; Sirolimus (W36ZG6FT64)
Language	English
Publishing date	2015-05-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201504-0768up
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Article ; Online: Idiopathic non-specific interstitial pneumonia.

Belloli, Elizabeth A / Beckford, Rosemarie / Hadley, Ryan / Flaherty, Kevin R

Respirology (Carlton, Vic.)

2016 Volume 21, Issue 2, Page(s) 259–268

Abstract: Non-specific interstitial pneumonia (NSIP) is an interstitial lung disease that may be idiopathic or secondary to connective tissue disease, toxins or numerous other causes. Idiopathic NSIP is a rare diagnosis and requires exclusion of these other ... ...

Abstract	Non-specific interstitial pneumonia (NSIP) is an interstitial lung disease that may be idiopathic or secondary to connective tissue disease, toxins or numerous other causes. Idiopathic NSIP is a rare diagnosis and requires exclusion of these other possible causes. Patients typically present in mid-adulthood with dyspnoea, cough and often constitutional symptoms including fever and fatigue. The disease has a female predominance, and more than 50% of patients have never smoked. Physical exam features mild hypoxaemia and inspiratory rales. Pulmonary function tests demonstrate restriction and a low diffusing capacity for carbon monoxide. High-resolution computed tomography abnormalities include predominantly lower lobe subpleural reticular changes, traction bronchiectasis and ground-glass opacities; honeycombing is rarely seen. An evaluation of the underlying pathology is necessary for a firm diagnosis. Histologically, alveolar and interstitial mononuclear cell inflammation and fibrosis are seen in a temporally uniform pattern with preserved underlying alveolar architecture. NSIP must be differentiated from other parenchymal lung diseases including idiopathic pulmonary fibrosis and hypersensitivity pneumonitis. A thorough exposure history and assessment for underlying connective tissue diseases are highly important, as positive findings in these categories would likely denote a case of secondary NSIP. A multi-disciplinary discussion that includes pulmonologist(s), radiologist(s) and pathologist(s) assists in reaching a consensus diagnosis and improves diagnostic accuracy. Treatment of idiopathic NSIP, although not well proven, is generally instituted in the form of immunosuppression. Prognosis is favourable compared with idiopathic pulmonary fibrosis, although the diagnosis still carries an attributable mortality. Herein we will summarize the clinical characteristics and management of idiopathic NSIP.
MeSH term(s)	Alveolitis, Extrinsic Allergic/diagnosis ; Diagnosis, Differential ; Disease Management ; Humans ; Idiopathic Interstitial Pneumonias/diagnosis ; Idiopathic Interstitial Pneumonias/physiopathology ; Idiopathic Pulmonary Fibrosis/diagnosis ; Inflammation/pathology ; Lung/pathology ; Lung/physiopathology ; Prognosis ; Symptom Assessment/methods ; Tomography, X-Ray Computed
Language	English
Publishing date	2016-02
Publishing country	Australia
Document type	Journal Article ; Review
ZDB-ID	1435849-9
ISSN	1440-1843 ; 1323-7799
ISSN (online)	1440-1843
ISSN	1323-7799
DOI	10.1111/resp.12674
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Article ; Online: Radiographic Graft Surveillance in Lung Transplantation: Prognostic Role of Parametric Response Mapping.

Belloli, Elizabeth A / Gu, Tian / Wang, Yizhuo / Vummidi, Dharshan / Lyu, Dennis M / Combs, Michael P / Chughtai, Aamer / Murray, Susan / Galbán, Craig J / Lama, Vibha N

American journal of respiratory and critical care medicine

2021 Volume 204, Issue 8, Page(s) 967–976

Abstract: Rationale: ...

Abstract	Rationale:
MeSH term(s)	Adult ; Aged ; Chronic Disease ; Clinical Decision Rules ; Early Diagnosis ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Diseases/diagnostic imaging ; Lung Diseases/mortality ; Lung Transplantation ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/mortality ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2021-07-28
Publishing country	United States
Document type	Evaluation Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.202012-4528OC
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Article ; Online: Reply to Fernández Pérez: Diagnostic Decision-Making in Hypersensitivity Pneumonitis: Toward a Consensus Statement.

Salisbury, Margaret L / Myers, Jeffrey L / Belloli, Elizabeth A / Kazerooni, Ella A / Martinez, Fernando J / Flaherty, Kevin R

American journal of respiratory and critical care medicine

2018 Volume 197, Issue 12, Page(s) 1647–1648

MeSH term(s)	Alveolitis, Extrinsic Allergic ; Consensus ; Decision Making ; Humans ; Pneumonia
Language	English
Publishing date	2018-03-03
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201801-0125LE
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Article ; Online: Fibroproliferation in chronic lung allograft dysfunction: Association of mesenchymal cells in bronchoalveolar lavage with phenotypes and survival.

Combs, Michael P / Xia, Meng / Wheeler, David S / Belloli, Elizabeth A / Walker, Natalie M / Braeuer, Russell R / Lyu, Dennis M / Murray, Susan / Lama, Vibha N

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

2020 Volume 39, Issue 8, Page(s) 815–823

Abstract: Background: Chronic lung allograft dysfunction (CLAD), the primary cause of poor outcome after lung transplantation, arises from fibrotic remodeling of the allograft and presents as diverse clinical phenotypes with variable courses. Here, we investigate ...

Abstract	Background: Chronic lung allograft dysfunction (CLAD), the primary cause of poor outcome after lung transplantation, arises from fibrotic remodeling of the allograft and presents as diverse clinical phenotypes with variable courses. Here, we investigate whether bronchoalveolar lavage (BAL) mesenchymal cell activity at CLAD onset can inform regarding disease phenotype, progression, and survival. Methods: Mesenchymal cell colony-forming units (CFUs) were measured in BAL obtained at CLAD onset (n = 77) and CLAD-free time post-transplant matched controls (n = 77). CFU counts were compared using Wilcoxon's rank-sum test. Cox proportional hazards and restricted means models were utilized to investigate post-CLAD survival. Results: Higher mesenchymal CFU counts were noted in BAL at the time of CLAD onset than in CLAD-free controls. Patients with restrictive allograft syndrome had higher BAL mesenchymal CFU count at CLAD onset than patients with bronchiolitis obliterans syndrome (p = 0.011). Patients with high mesenchymal CFU counts (≥10) at CLAD onset had worse outcomes than those with low (<10) CFU counts, with shorter average survival (2.64 years vs 4.25 years; p = 0.027) and shorter progression-free survival, defined as time to developing either CLAD Stage 3 or death (0.97 years vs 2.70 years; p < 0.001). High CFU count remained predictive of decreased overall survival and progression-free survival after accounting for the CLAD phenotype and other clinical factors in multivariable analysis. Conclusions: Fulminant fibroproliferation with higher mesenchymal CFU counts in BAL is noted in restrictive allograft syndrome and is independently associated with poor survival after CLAD onset.
MeSH term(s)	Adult ; Allografts ; Bronchiolitis Obliterans/surgery ; Bronchoalveolar Lavage Fluid/cytology ; Bronchoscopy ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Lung Transplantation ; Male ; Mesenchymal Stem Cells/cytology ; Middle Aged ; Phenotype ; Primary Graft Dysfunction/diagnosis ; Primary Graft Dysfunction/etiology ; Primary Graft Dysfunction/mortality ; Prospective Studies ; Survival Rate/trends ; United States/epidemiology
Language	English
Publishing date	2020-04-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1062522-7
ISSN	1557-3117 ; 1053-2498
ISSN (online)	1557-3117
ISSN	1053-2498
DOI	10.1016/j.healun.2020.04.011
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