Abstract S82 Table 1

Consensus (C) and majority (M) statements with level of agreement

Statement% agree
HP patients with an acute onset of severe symptoms (often with hypoxia) should be treated with short courses of oral corticosteroids, to speed up the rate of clinical improvement (C). 91%
In some cases of biopsy confirmed HP, fibrosis progresses despite cessation of exposure and treatment with immunosuppression (C). 96%
I have had patients with progressive fibrotic HP unresponsive to immunosuppression, whom I would have treated with antifibrotic agents, had they been routinely available as standard NHS care (C). 81%
In HP that progresses (despite cessation of exposure) immunosuppression should be considered (where not contraindicated):
- only if there is evidence of active inflammation
- in all cases irrespective of the radiological diagnosis or histological pattern (M)
- in all cases unless there is a definite UIP pattern of fibrosis
- other (please specify)
In HP with a predominantly fibrotic picture, immunosuppression should be stopped after a three-month trial unless there is a clear improvement or stabilisation of lung function (M). 67%
In HP with a predominantly fibrotic picture, I have concerns that treating patients long-term with immunosuppression may increase mortality as in IPF (M). 61%