Dr. Stacey Lok of Saskatchewan received a one-year $90,000 Robert Davidson Research Fellowship for 2019-20.
As a clinical research fellow at the University of Calgary, she spent about 20 per cent of her time caring for ILD patients, gaining valuable ILD clinical experience. The bulk of Dr. Lok’s time was devoted to research. Her main research project was titled: “Malignancy Risk Associated with the use of Mycophenolate Mofetil in Interstitial Lung Disease.”
Mycophenolate mofetil is a medication used to treat various forms of ILD such as hypersensitivity pneumonitis, which is triggered by an environmental exposure, and ILD secondary to autoimmune diseases, such as scleroderma, rheumatoid arthritis, lupus and myositis. It is not used to treat IPF. “This medication is known to increase the risk of cancer when used as an anti-rejection therapy following organ transplants,” said Dr. Lok, “But ILD patients are different. I’m investigating the cancer risk of mycophenolate mofetil in ILD patients.”
Dr. Lok used the Canadian Registry for Pulmonary Fibrosis (CARE-PF) database to analyze the risk of cancer for people with ILD, who have received Mycophenolate Mofetil across Canada. “I believe this is an important clinical question to help our patients with ILD weigh the benefits and risks of this therapy and for our clinicians to be able to counsel patients on cancer risk with the appropriate data.”
She and her colleagues reviewed the database to add the information needed, including new or recurring cancers, for the analysis for this study.
Dr. Jolene Fisher, Clinical Investigator with the University Health Network (UHN) and Assistant Professor at the University of Toronto (U of T) was awarded a $20,000 CPFF Research Grant for 2019-20.
Her primary objective was to determine the current incidence, prevalence, mortality and healthcare utilization of IPF in Ontario. This research aimed to act as a foundation for health policy decision making, advocacy and future research designed to improve the care and health outcomes of people living with IPF.
This led to a study of 1,285 patients, older than 18, who enrolled in the Canadian Registry for Pulmonary Fibrosis (CARE-PF) during its first 18 months (January 2016 to July 2017), which provided researchers with a broad overview of the characteristics of the disease in Canada.
“We found that more than 20 per cent of patients had what we call unclassifiable ILD, even after being assessed at an expert ILD centre,” said Dr. Fisher. “This was a surprise to me. It means that after all of the usual testing and a discussion involving several ILD doctors, the cause or type of pulmonary fibrosis couldn’t be determined. It’s frustrating for patients and physicians when we can’t determine the type of fibrosis with all of the usual testing.”
Other notable findings were that comorbidities (other medical conditions) and exposures are very common among all types of pulmonary fibrosis.
Baseline characteristics and comorbidities in the Canadian Registry for Pulmonary Fibrosis
Dr. W. Darlene Reid, Professor at U of T and Dr. Dmitry Rozenberg, Clinical Scientist – Respirology at Toronto General Research Institute and Assistant Professor at U of T. were awarded a $20,000 CPFF Research Grant for 2019-20.
They proposed to study diaphragm and thigh muscle strength and their respective sizes during hospitalization of 20 ILD patients while in hospital for acute exacerbation in interstitial lung disease (AE-ILD) and 3 months after discharge. This aimed to help better understand how these muscles change. In addition, they measured if low oxygen levels resulting from whole body stress could damage skeletal muscle. Lastly, they examined how diaphragm and thigh muscle size and function could affect mobility, daily function, quality of life, need for hospital re-admission and three-month survival.
This was the first study to describe the changes in respiratory and limb muscles during hospitalization of people with IPF. Their findings of how muscle structure and function change during hospital aim to help with exercise planning, home supports and may ultimately help improve the quality of life of those living with IPF.The interplay of physical and cognitive function in rehabilitation of interstitial lung disease patients: a narrative review