As Dr. Na’ama Avitzur heads into the home stretch of her two-year CPFF Robert Davidson fellowship at UBC and the ILD program at St. Paul’s Hospital in Vancouver, she is exploring some important research questions.
How does a specialist decide which drugs to use to treat different patients? Does anxiety or depression have an impact on patients continuing drug treatment? Do these patients experience more symptoms?
A literature review of treatable traits in PF
One such study Treatable traits in pulmonary fibrosis: towards precision medicine was submitted for publication in May 2025 and is now being reviewed for publication. A literature review of more than 100 published papers, this paper looks at specific traits or characteristics that can guide treatments, such as blood tests, imaging, and pathology, as well as new technologies like genetic markers. It looks at the current findings on who will respond better to different drug treatments. Dr. Avitzur is the lead author of the study involving six other contributors.
“This work should benefit patients by increasing the knowledge of all respirologists,” says Dr. Avitzur, “helping them treat ILD with more confidence. It provides clinicians with specific recommendations based on expert opinions.”
Primary project: Expert treatment patterns in patients with fibrotic ILD
The literature review ties into Dr. Avitzur’s primary research project Expert treatment patterns in patients with fibrotic interstitial lung disease, which is well underway. This study examines what patient features influence treatment decisions by expert ILD physicians, using previously collected patient information from the CARE-PF (Canadian Registry for Pulmonary Fibrosis).
200 real cases were selected, including medical histories, CT scans and radiologist reports, along with other information, and posted online. Survey questions were sent to 13 ILD experts to obtain their treatment recommendations for these specific cases. For some cases, a lung biopsy report was added later and the experts were asked whether, and how, the biopsy results changed their diagnosis and/or treatment plans.
Dr. Avitzur is currently in the data analysis phase of this study and plans to have a few manuscripts ready for submission before her fellowship ends in July 2026. “The results should help us understand which patient features lead expert clinicians to chose certain drug treatments,” says Dr. Avitzur. “It should provide insights into their decision-making processes that can be helpful to all respirologists.”
Anxiety and depression in patients with fibrotic ILD
Dr. Avitzur has completed another study Frequency and prognostic associations of anxiety and depression in fibrotic interstitial lung disease: a registry-based analysis, which she presented at the American Thoracic Society conference in May 2025 and will be submitted for publication this month.
This study involved analyzing chart review data collected from 4,000 CARE-PF cases and extracting information about diagnosis of anxiety or depression, the use of medication for these conditions, as well as associations between these conditions and other patient characteristics, such as gender, cough severity, lung function etc. She was also interested in determining whether patients with anxiety or depression were more likely to stop taking an anti-fibrotic medication or other medications to treat ILD than patients without these conditions.
She found that 18 percent of the charts documented patient anxiety or depression, with women more likely than men to report these conditions. Results also indicate that anxiety or depression did not impact whether a patient received appropriate drug treatment or increase the likelihood that they would stop taking an anti-fibrotic drug. Patients with these mental health conditions did experience worse cough and shortness of breath symptoms.
“Patients with these mental health conditions experience worse symptoms that impact their quality of life,” reports Dr. Avitzur. “Clinicians should be checking in with their patients to determine if they are experiencing anxiety or depression and treating these conditions along with their PF disease.”
Other pursuits and accomplishments
In addition to these three major studies, Dr. Avitzur worked with colleagues to write two “editorials” which have been published: How low can you go: exploring the role of low dose computed tomography in interstitial lung disease detection, in the Annals ATS, July 2025, and How opaque is ground glass on chest imaging, in Thorax, also in July 2025.
While in Vancouver, Dr. Avitzur has also been pursuing her Masters of Health Science at UBC. Her studies focus on various research methods, statistics and data analysis, and epidemiology (how often diseases occur in different groups of people and why.) She has been applying this knowledge as she conducts her Fellowship research projects.
Lastly, Dr. Avitzur spends about 25 per cent of her time caring for patients at the Interstitial Lung Disease Program at St. Paul’s Hospital. Here she is gaining expertise into caring for patients with the most complex cases of pulmonary fibrosis and is mentored by expert clinicians and researchers.
About the fellowship
“It’s been a very rewarding experience,” says Dr. Avitzur. “I cannot thank the CPFF enough for this opportunity to focus on clinical research and care for our ILD patients.”
Dr. Avitzur plans to return to Calgary when her fellowship ends in July 2026. There she will care for patients and continue doing research into pulmonary fibrosis.