RESUMEN
INTRODUCTION: The Smoking and the Diffuse Interstitial Lung Diseases (ILD) groups of ALAT and SEPAR collaborated in the preparation of this document. MATERIALS AND METHODS: This document uses PICO methodology to answer various questions on the relationship between tobacco use and diffuse ILD. RESULTS AND CONCLUSIONS: The main recommendations are: a) moderate level of evidence and strong recommendation to consider smoking as a risk factor for the development and/or modification of the progression of diffuse ILD; b) moderate level of evidence to identify an increase in mortality in diffuse ILD, irrespective of histologic pattern. Low evidence for ascribing it to smoking and strong recommendation for the early identification of patients with diffuse ILD. Further studies are needed to evaluate the effect of smoking cessation in patients with diffuse ILD; c) low level of evidence and weak recommendation for defining the impact of passive smoking in diffuse ILD; d) low level of evidence to demonstrate that smoking cessation improves the outcomes of patients diagnosed with diffuse ILD and strong recommendation to advise smoking cessation in smokers with diffuse ILD, and e) low level of evidence to support the clinical or epidemiological usefulness of active case finding for diffuse ILD in smoking cessation programs, and strong recommendation justifying the performance of spirometry in active case finding, based not on current smoking status, but on previous accumulated consumption, even in asymptomatic cases.
Asunto(s)
Enfermedades Pulmonares Intersticiales , Cese del Hábito de Fumar , Contaminación por Humo de Tabaco , Humanos , Fumar , EspirometríaRESUMEN
INTRODUCCIÓN: Los grupos de Tabaquismo y de Enfermedades Pulmonares Intersticiales Difusas (EPID) de ALAT y SEPAR han colaborado para la realización de este documento. MATERIAL Y MÉTODOS: En el mismo se da respuesta, siguiendo metodología PICO, a diferentes interrogantes sobre la relación entre el consumo de tabaco y las EPID. RESULTADOS Y CONCLUSIONES: Sus principales recomendaciones son: a) evidencia moderada y recomendación fuerte para considerar el tabaquismo como un factor de riesgo para el desarrollo y/o modificador de la progresión de EPID; b) evidencia moderada para identificar que existe un incremento de la mortalidad en la EPID independientemente de su patrón histológico. Evidencia baja para adjudicarlo al tabaquismo y recomendación fuerte para identificar a los pacientes con EPID precozmente. Se hacen necesarios nuevos estudios que evalúen el efecto de la cesación tabáquica en los pacientes con EPID; c) evidencia baja y recomendación débil para definir el impacto del tabaquismo de segunda mano en la EPID; d) evidencia baja para demostrar que la cesación tabáquica mejora los resultados de los pacientes diagnosticados de EPID y recomendación fuerte para aconsejar la cesación tabáquica en casos de EPID en fumadores, y e) evidencia baja que demuestre la utilidad clínica o epidemiológica de la búsqueda activa de los casos de EPID en los programas de cesación tabáquica y recomendación fuerte para justificar la realización de espirometría durante esta búsqueda independientemente del estatus actual de tabaquismo pero con la dosis acumulada previamente, aun en casos asintomáticos
INTRODUCTION: The Smoking and the Diffuse Interstitial Lung Diseases (ILD) groups of ALAT and SEPAR collaborated in the preparation of this document. MATERIALS AND METHODS: This document uses PICO methodology to answer various questions on the relationship between tobacco use and diffuse ILD. RESULTS AND CONCLUSIONS: The main recommendations are: a) moderate level of evidence and strong recommendation to consider smoking as a risk factor for the development and/or modification of the progression of diffuse ILD; b) moderate level of evidence to identify an increase in mortality in diffuse ILD, irrespective of histologic pattern. Low evidence for ascribing it to smoking and strong recommendation for the early identification of patients with diffuse ILD. Further studies are needed to evaluate the effect of smoking cessation in patients with diffuse ILD; c) low level of evidence and weak recommendation for defining the impact of passive smoking in diffuse ILD; d) low level of evidence to demonstrate that smoking cessation improves the outcomes of patients diagnosed with diffuse ILD and strong recommendation to advise smoking cessation in smokers with diffuse ILD, and e) low level of evidence to support the clinical or epidemiological usefulness of active case finding for diffuse ILD in smoking cessation programs, and strong recommendation justifying the performance of spirometry in active case finding, based not on current smoking status, but on previous accumulated consumption, even in asymptomatic cases