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) | 19% 50% 13% 4% |
| 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% |